Abstract
Robotic assisted surgery(RAS) has become increasingly adopted in colorectal cancer surgery. This studyaims to compare robotic and laparoscopic approaches to left sided colorectalresections in terms of surgical outcomeswith noformal enhanced recovery programme. All patients undergoing robotic orlaparoscopic left sided or rectal (high and low anterior resection) cancer surgeryat a single tertiary referral centre over 3 years were included.A total of 184 consecutive patients from July 2017 to December 2020 were included in this study, with 40.2%(n=74/184) undergoing RAS. The median age at time of surgery was 68 years (IQR60-73 years). RAS had a significantly shorter length of median stay of 3 days,compared to 5 days in the conventional laparoscopic surgery (CLS) group(p<0.001). RAS had a significantly lower rate of conversion to open surgery(0% vs 16.4%, p<0.001). The median operative time was also shorter in RAS(308 minutes), compared to CLS (326 minutes, p=0.019). The overall rate of anycomplication was 16.8%, with the RAS experiencing a lower complication rate(12.2% vs 20.0%, p=0.041). There was no significant difference in anastomoticleak rates between the two groups (4.0% vs 5.5%, p=0.673), or in terms of completeresection (R0) (robotic 98.6%, laparoscopic 100%, p=0.095). Robotic left sidedcolorectal surgery delivers equivalent oncological resection compared tolaparoscopic approaches, with the added benefits of reduced length of stay andlower rates of conversion to open surgery. This has both clinical andhealthcare economic benefits.
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