The effects of robotic-assisted versus laparoscopic-assisted radical right hemicolectomy on short-term outcome and long-term prognosis based on propensity score matching.
- Author:
Xing Qi ZHANG
1
;
Shou Gen CAO
1
;
Xiao Dong LIU
1
;
Ze Qun LI
1
;
Yu Long TIAN
1
;
Jian Fei XU
1
;
Cheng MENG
1
;
Yi LI
1
;
Xiao Jie TAN
1
;
Shang Long LIU
1
;
Dong GUO
1
;
Xue Long JIAO
1
;
Yu LI
1
;
Dong CHEN
1
;
Liang LYU
1
;
Jian ZHANG
1
;
Hai Tao JIANG
1
;
Zhao Jian NIU
1
;
Yan Bing ZHOU
1
Author Information
- Publication Type:Journal Article
- MeSH: Colectomy; Colonic Neoplasms/surgery*; Female; Humans; Laparoscopy; Male; Prognosis; Propensity Score; Retrospective Studies; Robotic Surgical Procedures; Treatment Outcome
- From: Chinese Journal of Surgery 2022;60(2):148-153
- CountryChina
- Language:Chinese
- Abstract: Objective: To compare the short-term and long-term outcomes between robotic-assisted and laparoscopic-assisted radical right hemicolectomy in patients with adenocarcinoma of the right colon. Methods: Retrospective review of a prospectively collected database identified 288 right colon cancer patients who underwent either robotic-assisted (n=57) or laparoscopic-assisted right hemicolectomy (n=231) between October 2014 and October 2020 at Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University. There were 161 males and 127 females, aging (60.3±12.8) years (range: 17 to 86 years). After propensity score matching as 1∶4 between robotic-assisted and laparoscopic-assisted right hemicolectomy, there were 56 cases in robotic group and 176 cases in laparoscipic group. Perioperative outcomes and overall survival were compared between the two groups using t test, Wilcoxon rank sum test, χ2 test, Fisher exact test, Kaplan-Meier method and Log-rank test, respectively. Results: The total operative time was similar between the robotic and laparoscopic group ((206.9±60.7) minutes vs. (219.9±56.3) minutes, t=-1.477, P=0.141). Intraoperative bleeding was less in the robotic group (50 (20) ml vs. 50 (50) ml, Z=-4.591, P<0.01), while the number of lymph nodes retrieved was significantly higher (36.0±10.0 vs. 29.0±10.1, t=4.491, P<0.01). Patients in robotic group experienced significantly shorter hospital stay, shorter time to first flatus, and defecation (t: -2.888, -2.946, -2.328, all P<0.05). Moreover, the overall peri-operative complication rate was similar between robotic and laparoscopic group (17.9% vs. 22.7%, χ²=0.596,P=0.465). The 3-year overall survival were 92.9% and 87.9% respectively and the 3-year disease-free survival rates were 83.1% and 82.6% with no statistical significance between the robotic and laparoscopic group (P>0.05). Conclusions: Compared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.
