Oncologic outcomes for robotic versus laparoscopic colectomy for colon cancer: an ACS-NSQIP analysis

• Published in: Journal of robotic surgery 2024-09, Vol.18 (1), p.341, Article 341
• Main Authors: de Almeida Leite, Rodrigo Moisés, Araujo, Sergio Eduardo Alonso, Callado, Gustavo Yano, Bossie, Hannah, Ricciardi, Rocco
• Format: Article
• Language: English
• Subjects: Aged; Blood transfusion; Blood transfusions; Body mass index; Cancer therapies; Chemotherapy; Codes; Colectomy - methods; Colonic Neoplasms - surgery; Colorectal cancer; Diabetes; Diabetes mellitus; Female; Heart failure; Humans; Hypertension; Kidney diseases; Laparoscopy; Laparoscopy - methods; Length of stay; Length of Stay - statistics & numerical data; Lymphatic system; Male; Medicine; Medicine & Public Health; Middle Aged; Minimally Invasive Surgery; Morbidity; Mortality; Ostomy; Patients; Postoperative period; Propensity Score; Regression models; Robotic surgery; Robotic Surgical Procedures - methods; Statistical analysis; Surgeons; Surgery; Surgical outcomes; Treatment Outcome; Urology
• ISSN: 1863-2491; 1863-2483; 1863-2491
• DOI: 10.1007/s11701-024-02097-0

Robotic colectomy has been associated with comparable or improved short-term morbidity and mortality when compared to laparoscopic colectomy, including shorter length of stay. In this study, we sought to understand oncologic advantages for robotic as compared to laparoscopic colectomy in colon cancer. We analyzed the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) participant user files for all elective colon cancer cases from 1/2016 through 12/2021 performed with minimally invasive surgical techniques (robotic and laparoscopic). We calculated relative risks (RR) through Poisson Regression models and treatment effect coefficients by propensity-score match, after adjusting for age, BMI, ASA scores, mechanical and antibiotic bowel preparation, emergency surgery, race, gender, smoking status, hypertension and diabetes mellitus. Analyzed outcomes included rate of chemotherapy initiation within 90 days of surgery, number of harvested lymph nodes, any occurrence of intraoperative or postoperative blood transfusion, and the need for ostomy. During the study period, 44,745 patients underwent minimally invasive colectomy for colon cancer; 39,614 in the laparoscopic cohort and 7,831 in the robotic cohort. After adjusting for confounders, robotic colectomy was associated with a significant increase in the likelihood for initating chemotherapy within 90 days (RR 1.98, 95% CI {1.86—2.10}, p