Minimally invasive right versus left colectomy for cancer: does robotic surgery mitigate differences in short-term outcomes?

Studies comparing right (RC) and left colectomies (LC) show higher rates of ileus in RC and higher wound infection and anastomotic leak rates in LC. However, prior studies did not include robotic procedures. We compared short-term outcomes of laparoscopic and robotic RC and LC for cancer, with sub-analysis of robotic procedures. In a retrospective review of a prospective database, preoperative factors, intraoperative events, and 30-day postoperative outcomes were compared. Student's t tests and Chi-square tests were used for continuous and categorical variables, respectively. A logistic binomial regression was performed to assess whether type of surgery was associated with postoperative complications. Between January 2014 and August 2020, 115 patients underwent minimally invasive RC or LC for cancer. Sixty-eight RC [30 (44.1%) laparoscopic, 38 (55.9%) robotic] and 47 LC [13 (27.6%) laparoscopic, 34 (72.4%) robotic] cases were included. On univariate analysis, RC patients had significantly higher overall postoperative complications but no differences in rates of ileus/small bowel obstruction, wound infection, time to first flatus/bowel movement, length of hospital stay, and 30-day readmissions. On multivariate analysis, there was no significant difference in overall complications and laparoscopic surgery had a 2.5 times higher likelihood of complications than robotic surgery. In sub-analysis of robotic cases, there was no significant difference among all outcome variables. Previously reported outcome differences between laparoscopic RC and LC for cancer may be mitigated by robotic surgery.

Automated summary

Comparing short-term outcomes of laparoscopic and robotic right colectomies (RC) and left colectomies (LC) for cancer, the study found that RC patients had higher overall postoperative complications, but no significant differences in other outcome variables. Multivariate analysis showed no significant difference in overall complications, with laparoscopic surgery having a 2.5 times higher likelihood of complications compared to robotic surgery. In the sub-analysis of robotic cases, there were no significant differences among all outcome variables. The study suggests that robotic surgery may help reduce the previously reported outcome differences between laparoscopic RC and LC for cancer.