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Techniques in Coloproctology

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25.03.2023 | Original Article

Robotic versus laparoscopic left colectomy with complete mesocolic excision for left-sided colon cancer: a multicentre study with propensity score matching analysis

verfasst von: H. Zheng, Q. Wang, T. Fu, Z. Wei, J. Ye, B. Huang, C. Li, B. Liu, A. Zhang, F. Li, F. Gao, W. Tong

Erschienen in: Techniques in Coloproctology | Ausgabe 7/2023

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Abstract

Background

Robotic surgery for right-sided colon and rectal cancer has rapidly increased; however, there is limited evidence in the literature of advantages of robotic left colectomy (RLC) for left-sided colon cancer. The purpose of this study was to compare the outcomes of RLC versus laparoscopic left colectomy (LLC) with complete mesocolic excision (CME) for left-sided colon cancer.

Methods

Patients who had RLC or LLC with CME for left-sided colon cancer at 5 hospitals in China between January 2014 and April 2022 were included. A one-to-one propensity score matched analysis was performed to decrease confounding. The primary outcome was postoperative complications occurring within 30 days of surgery. Secondary outcomes were disease-free survival, overall survival and the number of harvested lymph nodes.

Results

A total of 292 patients (187 males; median age 61.0 [20.0−85.0] years) were eligible for this study, and propensity score matching yielded 102 patients in each group. The clinical–pathological characteristics were well-matched between groups. The two groups did not differ in estimated blood loss, conversion to open rate, time to first flatus, reoperation rate, or postoperative length of hospital stay (p > 0.05). RLC was associated with a longer operation time (192.9 ± 53.2 vs. 168.9 ± 52.8 minutes, p=0.001). The incidence of postoperative complications did not differ between the RLC and LLC groups (18.6% vs. 17.6%, p = 0.856). The total number of lymph nodes harvested in the RLC group was higher than that in the LLC group (15.7 ± 8.3 vs. 12.1 ± 5.9, p< 0.001). There were no significant differences in 3-year and 5-year overall survival or 3-year and 5-year disease-free survival.

Conclusions

Compared to laparoscopic surgery, RLC with CME for left-sided colon cancer was found to be associated with higher numbers of lymph nodes harvested and similar postoperative complications and long-term survival outcomes.

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Titel: Robotic versus laparoscopic left colectomy with complete mesocolic excision for left-sided colon cancer: a multicentre study with propensity score matching analysis
verfasst von: H. Zheng
Q. Wang
T. Fu
Z. Wei
J. Ye
B. Huang
C. Li
B. Liu
A. Zhang
F. Li
F. Gao
W. Tong
Publikationsdatum: 25.03.2023
Verlag: Springer International Publishing
Erschienen in: Techniques in Coloproctology / Ausgabe 7/2023
Print ISSN: 1123-6337
Elektronische ISSN: 1128-045X
DOI: https://doi.org/10.1007/s10151-023-02781-7

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