Abstract
Background: Laparoscopy-assisted surgery (LAS) for colorectal cancer (CRC) was first described in 1991 and robotic-assisted surgery (RAS) for CRC was first reported in 2002; robotic-assisted colorectal surgery (RACS) is becoming increasingly popular. However, data comparing its outcomes to other established techniques remain limited to small case series. Our primary goal was to review the mortality outcome difference between laparoscopic versus robotic elective colon resection at a small, community hospital.Study design: We conducted a retrospective review of 2089 patients at the South Atlantic division for cases who underwent robotic and laparoscopic colectomies at our division in 2014-2018. All cases were elective surgeries and analysis was performed within these two subgroups.Results: In this study, 306 patients underwent robotic colorectal surgery versus 1783 patients who underwent laparoscopic-assisted colorectal surgery. Readmission rate within 30 days of operation was significantly lower for laparoscopic-assisted colorectal resection (LACR) versus RACS (445.4% vs. 53.9%, p= 0.006). However, the length of hospital stay was significantly shorter for RACS with a median of three days (interquartile range {IQR}: 2-5) versus four days (IQR: 3-7) for LACR (p=0.0001). There were no significant differences between the two groups for post-operative incisional hernias, anastomotic leaks, post-operative pain control, surgical site infections, or rate of conversion to an open procedure.Conclusion: Our study showed a similar outcome between LACR and RACS for post-operative incisional hernias, anastomotic leaks, post-operative pain control, surgical site infections, and rate of conversion to an open procedure. Also, our study showed a readmission rate within 30 days of operation was significantly lower for LACR versus RACS. However, the length of hospital stay was significantly shorter for RACS with a median of three days when compared to LACR. Future research should focus on surgeon-specific variables, such as comfort, ergonomics, distractibility, and ease of use, as other ways to potentially distinguish robotic from laparoscopic colorectal surgery.
Highlights
The surgical resection of colorectal disease processes has been significantly advanced over the last three decades
Readmission rate within 30 days of operation was significantly lower for laparoscopic-assisted colorectal resection (LACR) versus robotic-assisted colorectal surgery (RACS) (445.4% vs. 53.9%, p= 0.006)
Readmission rate within 30 days of operation eight was significantly lower for LACR versus Robotic-assisted colorectal resection (RACR) (45.4% vs. 53.9%, p=0.006)
Summary
The surgical resection of colorectal disease processes has been significantly advanced over the last three decades. With the advent of laparoscopic surgery in 1991, the surgical intervention of colorectal disease has become less invasive leading to decreased hospital stays and shorter recovery times, compared to conventional, open surgery [1]. Even though laparoscopic surgery has improved the surgical management of colorectal disease, robotic surgery has quickly surpassed laparoscopic surgery by improving the surgeon’s ability to perform complex colorectal resections [2]. Robotic-assisted colorectal surgery (RACS) is becoming increasingly popular, but data comparing outcomes to other established techniques remain limited to small case series [4]. There is still a great deal that we need to know before we fully understand the benefits of robotic surgery for surgical management of colorectal disease, among which are lower conversion rates to open surgery, better oncological outcomes, and nerve preservation [5]. Our primary goal was to review the mortality outcome difference between laparoscopic versus robotic elective colon resection at a small, community hospital
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
