Outcomes Of Robotic And Laparoscopic Right Colectomy With Complete Mesocolic Excision For The Treatment Of Colon Cancer

Objective:To analyze outcomes of robotic and laparoscopic right colectomy with complete mesocolic excision for the treatment of right-sided colon cancerin order to evaluate the feasibility and safety of robotic surgery system.Methods: From July 2016 to December 2021,a retrospective cohort was performed on169 consecutive patients who underwent minimally invasive radical right colectomy with complete mesocolic excision(CME)for right-sided colon cancerin our department.Of these patients,61 cases undergoing Da Vinci robotic surgical system-assisted radical right colectomy with CME were allocated into the robotic group and the other 108 cases undergoing laparoscopy-assisted radical right colectomy with CME were allocated into the laparoscopic group.Perioperative,pathological and oncological outcomes were collected and analysed.Results: There were no perioperative death in both groups.The robotic group showed a significant reduction in conversion rate(0% vs.6.5%,P=0.042),but a longer operative time [(221.1 52.6)min vs.(186.0±42.2)min,P<0.001].The total hospital costof the robotic group was significantly higher than that of the laparoscopic group[(90371.5±15843.7)yuan vs.(65136.3±14669.5)yuan,P< 0.001].No significant differenceswere observed in blood loss,oral re-intake,time to return of bowel function,length of stay between both groups(P>0.05).The perioperative complication rate was similar between both groups[12(19.7%)vs.22(20.4%),P>0.05].No marked differences were found in harvested lymph nodes(17.8 ± 5.1 vs.17.5 ± 5.4,P>0.05).At a median follow-up time was 31 months(range,1-65),the disease-free survival rates were 82.6% vs.82.8%(P>0.05)and over-all survival rates were 87.9% vs.84.3%(P>0.05)in the robot group and the laparoscopic group,respectively.Conclusion: Robotic right colectomy with CME is equally safe and feasible to laparoscopic right colectomy with CME for colon carcinoma with good outcomes.Future prospective randomized trials are needed to define its role for treatment of right colectomy.