4.4 Article

Right colectomy: consecutive 100 patients treated with laparoscopic and robotic technique for malignancy. Cumulative experience in a single centre

Journal

UPDATES IN SURGERY
Volume 71, Issue 1, Pages 151-156

Publisher

SPRINGER-VERLAG ITALIA SRL
DOI: 10.1007/s13304-018-0599-0

Keywords

Robotic surgery; Right colectomy; Laparoscopy; Colorectal cancer; Intracorporeal anastomosis; Learning curve

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Robotic-assisted resections prove beneficial in overcoming potential limitation of laparoscopy, but clear evidences on patient's benefits are still lacking. We report our experience on 100 consecutive patients who underwent right colectomy with either robotic or laparoscopic approaches. Data were prospectively collected on a dedicated database (ASA score, age, operative time, conversion rate, re-operation rate, early complications, length of stay, and pathological results). Median total operative time was 160min in LS group (IQR=140-180) and 204min for RS group (IQR=180-230). Median time to first flatus was 2.5days for LS group (IQR=2 - 3) and 2days for RS group (IQR=1-2). Length of stay (median) was 8days in LS group (IQR=6-10) and 5days in RS group (IQR=5-7). No statistically significant difference was found between the 2 groups when the number of harvested nodes, the anastomotic leakage and the postoperative bleeding were analyzed. The 30-day mortality was 0% in LS and RS groups. Conversion rate for LS group was 14% (7/50 pts) and for RS group was 0% (0/50). Minimally invasive surgery is a feasible and safe technique. The RS may overcome some technical limitations of laparoscopic surgery andit achieves the same oncological results compared to LS but with higher costs. The lower conversion rate allows to expect better clinical outcomes and lower complication rate.

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