Leonardo Solaini1,2, Davide Cavaliere3, Francesca Pecchini4, Federico Perna5, Francesca Bazzocchi3, Andrea Avanzolini3, Domenico Marchi4, Paolo Checcacci5, Alessandro Cucchetti3,6, Andrea Coratti5, Micaela Piccoli4, Giorgio Ercolani3,6. 1. General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy. leonardo.solaini2@unibo.it. 2. Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy. leonardo.solaini2@unibo.it. 3. General and Oncologic Surgery, Morgagni-Pierantoni Hospital, Ausl Romagna, Forlì, Italy. 4. Division of General, Emergency Surgery and New Technologies, OCSAE (Ospedale Civile Sant'Agostino Estense), Baggiovara, Modena, Italy. 5. Division of Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy. 6. Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy.
Abstract
BACKGROUND: In literature, most of the comparative studies of robotic (RRC) versus laparoscopic (LRC) right colectomy are biased by the type of the anastomotic technique adopted. With this study, we aim to understand whether there is a role for robotics in performing right colectomies, comparing RRC versus LRC, both performed with intracorporeal anastomosis. METHODS: In this retrospective cohort study, all consecutive patients who underwent minimally invasive right colectomy (robotic or laparoscopic) with intracorporeal anastomosis in three Italian high-volume centers between February 1, 2007 and December 31, 2017 were included. Patients were grouped according to the method of surgery: RRC or LRC. RESULTS: A total of 389 patients were included in the study (305 RRC vs. 84 LRC). Patients' baseline characteristics were comparable between the groups. Operative time was significantly longer in RRC (250 min, IQR 209-305) group than LRC group (160 min, IQR 130-200) (p < 0.001). The median number of lymph nodes harvested was 22 (IQR 18-29) in RRC group while it was 19 (IQR 15-27) in LRC one (p = 0.028). No significant differences between the groups were seen in terms of time-to-first flatus, postoperative complications and length of hospital stay. Re-admission rate was significantly higher in LRC (n = 3, 3.6%) group than in RRC group (n = 1, 0.3%) (p = 0.033). CONCLUSIONS: In conclusion, RRC and LRC are comparable in terms of functional postoperative outcomes and length of hospital stay. RRC requires longer operative time, but the number of lymph nodes harvested may be higher.
BACKGROUND: In literature, most of the comparative studies of robotic (RRC) versus laparoscopic (LRC) right colectomy are biased by the type of the anastomotic technique adopted. With this study, we aim to understand whether there is a role for robotics in performing right colectomies, comparing RRC versus LRC, both performed with intracorporeal anastomosis. METHODS: In this retrospective cohort study, all consecutive patients who underwent minimally invasive right colectomy (robotic or laparoscopic) with intracorporeal anastomosis in three Italian high-volume centers between February 1, 2007 and December 31, 2017 were included. Patients were grouped according to the method of surgery: RRC or LRC. RESULTS: A total of 389 patients were included in the study (305 RRC vs. 84 LRC). Patients' baseline characteristics were comparable between the groups. Operative time was significantly longer in RRC (250 min, IQR 209-305) group than LRC group (160 min, IQR 130-200) (p < 0.001). The median number of lymph nodes harvested was 22 (IQR 18-29) in RRC group while it was 19 (IQR 15-27) in LRC one (p = 0.028). No significant differences between the groups were seen in terms of time-to-first flatus, postoperative complications and length of hospital stay. Re-admission rate was significantly higher in LRC (n = 3, 3.6%) group than in RRC group (n = 1, 0.3%) (p = 0.033). CONCLUSIONS: In conclusion, RRC and LRC are comparable in terms of functional postoperative outcomes and length of hospital stay. RRC requires longer operative time, but the number of lymph nodes harvested may be higher.
Entities:
Keywords:
Anastomosis; Laparoscopy; Minimally invasive right colectomy; Outcomes; Robotic surgery