Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients

G. Spinoglio, P.P. Bianchi, A. Marano, F. Priora, L.M. Lenti, F. Ravazzoni, W. Petz, S. Borin, D. Ribero, G. Formisano, E. Bertani

Research output: Contribution to journalArticle

Abstract

Background: During the past decade, the concept of complete mesocolic excision (CME) has emerged as a possible strategy to minimize recurrence for right colon cancers. The purpose of this study was to compare robotic versus laparoscopic CME in performing right colectomy for cancer. Methods: Pertinent data of all patients who underwent robotic or laparoscopic right colectomy with CME using a Pfannenstiel incision and intracorporeal anastomosis performed between October 2005 and November 2015 were entered in a prospectively maintained database. Results: A total of 202 patients underwent robotic (n = 101) or laparoscopic (n = 101) right colectomy within the study period. Patient characteristics were equivalent between groups. The robotic group showed a statistically significant reduction in conversion rate (0% vs. 6.9%, p = 0.01) but a longer operative time (279 min vs. 236 min, p <0.001) compared with the laparoscopic group. There were no other differences in perioperative clinical or pathological outcomes. Five-years overall survival was 77 versus 73 months for the robotic versus laparoscopic groups (p = 0.64). The disease-free survival (DFS) rates were 85% and 83% for the robotic versus laparoscopic groups (p = 0.58). Among UICC stage III patients, there was a slight but not significant difference in 5-year DFS for the robotic group (81 vs. 68 months; p = 0.122). Conclusions: Both approaches for right colectomy with CME were safe and feasible and resulted in excellent survival. Robotic assistance was beneficial for performing intracorporeal anastomosis and dissection as evidenced by the lower conversion rates. Further robotic experience may shorten the operative time. © 2018, Society of Surgical Oncology.
Original languageEnglish
Pages (from-to)3580-3586
Number of pages7
JournalAnnals of Surgical Oncology
Volume25
Issue number12
DOIs
Publication statusPublished - 2018

Keywords

  • acute heart infarction
  • acute respiratory failure
  • adult
  • aged
  • anastomosis leakage
  • Article
  • bowel occlusion
  • brain ischemia
  • cancer patient
  • cancer specific survival
  • cancer surgery
  • cancer survival
  • colon cancer
  • colon resection
  • controlled study
  • disease free survival
  • excision
  • female
  • follow up
  • gastrointestinal hemorrhage
  • heart arrhythmia
  • hemoperitoneum
  • human
  • intermethod comparison
  • laparoscopic surgery
  • lobar pneumonia
  • major clinical study
  • male
  • operation duration
  • overall survival
  • perioperative period
  • peroperative complication
  • postoperative complication
  • postoperative hemorrhage
  • postoperative ileus
  • postoperative vomiting
  • robot assisted surgery
  • sudden cardiac death
  • surgical infection
  • urine retention

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