Robotic Versus Laparoscopic Colorectal Surgery: A Case Matched Study From a Tertiary Referral Center

Emre Gorgun, Erman Aytac, Brooke Gurland, Meagan M Costedio. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio.

INTRODUCTION: Robotic assisted colorectal surgery is an emerging technique. In this study we aimed to compare peri-operative and short-term outcomes of robotic colorectal operations to laparoscopy.

METHODS AND PROCEDURES: Patients undergoing robotic colorectal surgery between 11/2010 and 7/2013 were included. Robotic cases were case-matched to laparoscopic counterparts based on diagnosis and operation type. Operative and short-term postoperative outcomes were compared. Quantitative data were reported as mean±standard deviation and categorical data as numbers.

RESULTS: There were 57 patients who underwent robotic colorectal surgery. There were no differences between the groups in terms of age (52 vs.57 years;p=0.29), gender (29 vs.35 males;p=0.26), body mass index (28 vs.28 kg/m2;p=0.94) and history of previous abdominal operations (22 vs.21;p=0.85). ASA score was higher in patients who underwent robotic surgery (2 vs.3;p=0.01). Blood loss (300 vs.374 ml;p=0.27) and conversion rate to open surgery (6 vs.5;p=0.75) were similar between the groups. Operating time was longer in robotic surgery (185 vs.267 min;p<.0001). Time to first bowel movement (4 vs.4 days;p=0.38), hospital stay (7 vs.8 days;p=0.22) and postoperative complications were comparable between the groups (table).

CONCLUSIONS: Our early experience in robotic colorectal surgery shows similar short-term outcomes when compared to a carefully matched group of patients who underwent conventional laparoscopy. With increasing experience and numbers, the benefits of robotic colorectal surgery may declare.

Operations performed, diagnosis and specific complications
P value
Operations performed, (n)  >0.99
Abdominoperineal resection1414 
Completion proctectomy/proctocolectomy end ileostomy22 
Ileal pouch anal anastomosis99 
Right colectomy11 
Diagnosis, (n)  >0.99
Crohn’s disease34 
Rectal prolapse1111 
Ulceratice colitis98 
Specific complications, (n)   
Abdomino-pelvic abscess140.36
Anastomotic leak250.44
Stoma retraction10>0.99
Postoperative bleeding200.5
Wound infection21>0.99
Urinary retention55>0.99
Urinary tract infection300.24
Venous thromboembolism11>0.99
Overall morbidity, (n)24230.85
Mortality, (n)10>0.99
Reoperation, (n)34>0.99
Readmission, (n)690.41


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