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Title: Robotic versus laparoscopic right hemicolectomy: a retrospective cohort study of the Binational Colorectal Cancer Database.
Austin Authors: Clarke, Edward M ;Rahme, Jessica ;Larach, Tomas;Rajkomar, Amrish;Jain, Anshini;Hiscock, Richard;Warrier, Satish;Smart, Philip J 
Affiliation: Mercy Perinatal, Mercy Hospital for Women, Heidelberg, Melbourne, VIC, 3084, Australia
General Surgery and Gastroenterology Clinical Institute, Epworth HealthCare, Richmond, Melbourne, VIC, 3121, Australia
Department of Surgery, Eastern Health, Box Hill, Melbourne, VIC, 3128, Australia
Translational Obstetrics Group, Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, VIC, 3010, Australia
Department of Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
Issue Date: 2022
Date: 2021-10-28
Publication information: Journal of Robotic Surgery 2022; 16(4): 927-933
Abstract: Robotic right hemicolectomy (RRC) may have technical advantages over the conventional laparoscopic right colectomy (LRC) due to higher degrees of rotation, articulation, and tri-dimensional imaging. There is growing literature describing advantages of RRC compared to LRC; however, there is a lack of evidence about safety, oncologic quality of surgery and cost. This study aimed to analyse complication rates, length of stay and nodal harvest in patients undergoing minimally invasive right hemicolectomy for colon cancer from a prospective Australasian colorectal cancer database. This was a retrospective cohort study using nearest neighbour matching. The Binational Colorectal Cancer Audit (BCCA) provided the data for analysis. The primary outcome was length of stay. Secondary outcomes were harvested lymph node count, anastomotic leak, postoperative haemorrhage, abdominal abscess, postoperative ileus, wound infections and non-surgical complications. 4977 patients who underwent robotic (n = 146) or laparoscopic (n = 4831) right hemicolectomy for right-sided colon cancer were included. For RRC, LOS was shorter (5 vs 6.9 days, p = 0.01) and nodal harvest was higher (22 vs 19, p = 0.04). For RRC, surgical complications (5.9% vs 14.2%, p < 0.004) and non-surgical complications (4.6% vs 11.7%, p = 0.007) were lower though there was no difference in return to theatre or inpatient death. Robotic right hemicolectomy is associated shorter LOS and marginally higher lymph node count, though this may reflect anastomotic technique rather than surgical platform. Longer term studies are required to establish differences in overall survival, incisional hernia rates and cost effectiveness.
DOI: 10.1007/s11701-021-01319-z
ORCID: 0000-0002-5611-5558
Journal: Journal of Robotic Surgery
PubMed URL: 34709537
Type: Journal Article
Subjects: Colectomy
Colorectal neoplasms
Intracorporeal anastomosis
Robotic surgical procedures
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