The effects of robotic-assisted versus laparoscopic-assisted radical right hemicolectomy on short-term outcome and long-term prognosis based on propensity score matching
Zhang Xingqi, Cao Shougen, Liu Xiaodong, Li Zequn, Tian Yulong, Xu Jianfei, Meng Cheng, Li Yi, Tan Xiaojie, Liu Shanglong, Guo Dong, Jiao Xuelong, Li Yu, Chen Dong, Lyu Liang, Zhang Jian, Jiang Haitao, Niu Zhaojian, Zhou Yanbing
Abstract
ObjectiveTo 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.
MethodsRetrospective 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.
ResultsThe 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±10.0vs. 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).
ConclusionsCompared to laparoscopic-assisted right hemicolectomy, robot-assisted right hemicolectomy could improve some short-term clinical outcomes. The two procedures are both achieving comparable survival.
Key words:
Colonic neoplasms; Colectomy; Robotics; Laparoscopy; Therapy outcome
Contributor Information
Zhang Xingqi
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Cao Shougen
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Liu Xiaodong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Li Zequn
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Tian Yulong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Xu Jianfei
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Meng Cheng
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Li Yi
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Tan Xiaojie
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Liu Shanglong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Guo Dong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Jiao Xuelong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Li Yu
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Chen Dong
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Lyu Liang
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Zhang Jian
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Jiang Haitao
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Niu Zhaojian
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Zhou Yanbing
Department of Gastrointestinal Surgery, the Affiliated Hospital of Qingdao University, Qingdao 266003, China