Comparison of Short-Term Outcomes Between Robotic-Assisted and Laparoscopic Surgery in Colorectal Cancer

Surg Innov. 2019 Feb;26(1):57-65. doi: 10.1177/1553350618797822. Epub 2018 Sep 7.

Abstract

Aim: The robotic technique has been established as an alternative approach to laparoscopy in colorectal surgery. The aim of this study was to compare short-term outcomes of robot-assisted and laparoscopic surgery in colorectal cancer.

Methods: The cases of robot-assisted or laparoscopic colorectal resection were collected retrospectively between July 2015 and October 2017. We evaluated patient demographics, perioperative characteristics, and pathologic examination. A multivariable linear regression model was used to assess short-term outcomes between robot-assisted and laparoscopic surgery. Short-term outcomes included time to passage of flatus and postoperative hospital stay.

Results: A total of 284 patients were included in the study. There were 104 patients in the robotic colorectal surgery (RCS) group and 180 in the laparoscopic colorectal surgery (LCS) group. The mean age was 60.5 ± 10.8 years, and 62.0% of the patients were male. We controlled for confounding factors, and then the multiple linear model regression indicated that the time to passage of flatus in the RCS group was 3.45 days shorter than the LCS group (coefficient = -3.45, 95% confidence interval [CI] = -5.19 to -1.71; P < .001). Additionally, the drainage of tube duration (coefficient = 0.59, 95% CI = 0.3 to 0.87; P < .001) and transfers to the intensive care unit (coefficient = 7.34, 95% CI = 3.17 to 11.5; P = .001) influenced the postoperative hospital stay. The total costs increased by 15501.48 CNY in the RCS group compared with the LCS group ( P = .008).

Conclusions: The present study suggests that colorectal cancer robotic surgery was more beneficial to patients because of shorter postoperative recovery time of bowel function and shorter hospital stays.

Keywords: colon rectal; colorectal cancer; laparoscopy surgery; rectal cancer; robotic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Blood Loss, Surgical
  • China
  • Cohort Studies
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Colorectal Surgery / adverse effects
  • Colorectal Surgery / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Operative Time
  • Patient Selection
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Time Factors
  • Treatment Outcome