Short-Term Outcomes with Robotic Right Colectomy.

Abstract

Few series have reported on the impact of robotic right colectomy compared with conventional laparoscopy. Even fewer have reported on the outcomes of intracorporeal anastomoses. The aim of our study was to determine the impact of robotic surgery on short-term operative outcomes in patients undergoing right colectomy with intracorporeal anastomosis. One hundred and fourteen consecutive patients who underwent a right colectomy by two colorectal surgeons between 2012 and 2017 were included. Patients were separated into two groups: laparoscopic technique with extracorporeal anastomosis (n = 87) and robotic technique with intracorporeal anastomosis (n = 27). Univariate analysis was performed to determine differences in outcomes. Differences between cohorts were only identified with regard to gender (62 vs 37%, P = 0.022) and year of surgery. In comparison with laparoscopy, robotic colectomy resulted in a shorter time of GI recovery (1.3 ± 0.6 vs 3 ± 1.1, P < 0.0001), lower rates of postoperative ileus (4 vs 28%, P = 0.007), lower overall morbidity (26 vs 52%, P = 0.019), less blood loss (P = 0.001), 50 per cent lower narcotic use, and longer operative time (255 ± 66 vs 139 ± 49, P < 0.001). Despite longer operative time, robotic surgery improved GI recovery, significantly lowered oral morphine equivalent usage, and decreased short-term complications.

• Authors: Scott R Kelley, Emilie Duchalais, David W Larson
• Journal: The American surgeon (Am Surg) Vol. 84 Issue 11 Pg. 1768-1773 (Nov 01 2018) ISSN: 1555-9823 [Electronic] United States
• PMID: 30747631 (Publication Type: Comparative Study, Journal Article)

Topics

• Aged
• Analysis of Variance
• Anastomosis, Surgical (methods)
• Cohort Studies
• Colectomy (adverse effects, methods)
• Colonic Neoplasms (mortality, pathology, surgery)
• Female
• Humans
• Laparoscopy (adverse effects, methods)
• Length of Stay
• Male
• Middle Aged
• Operative Time
• Pain, Postoperative (epidemiology, physiopathology)
• Patient Safety
• Postoperative Complications (epidemiology, physiopathology)
• Prognosis
• Retrospective Studies
• Risk Assessment
• Robotic Surgical Procedures (adverse effects, methods)
• Statistics, Nonparametric
• Survival Rate
• Treatment Outcome