Anderson Lee, BS, Arman Alizadeh, BS, Jason Cohen, MD, Joshua D Ellenhorn, MD, Yosef Nasseri, MD. The Surgery Group of Los Angeles
Introduction: Colorectal surgery has recently had the steepest rise in rate of adoption of the robotic approach. However, there is still no consensus on its merit compared with laparoscopic colectomies. We compared our short term outcomes of case matched robotic and laparoscopic colectomies.
Methods and Procedures: We included our first 55 robotic colectomies through retrospective review of a prospective database of patients between February 2014 and July 2017. These patients were matched with 55 laparoscopic colectomies based on operation type, age, body mass index (BMI), American Society of Anesthesiology (ASA) score, and a conglomerate of relevant risk factors: obesity, diabetes, renal failure, pulmonary, and cardiac diseases. Outcomes compared were operative time, conversion rate, overall complications, gastrointestinal (GI) related complications (wound infection, abdominal abscess, anastomotic leak, ileus and small bowel obstruction), hospital length of stay, and 30-day re-admission rate. Two sample t-test was used and p< 0.05 was considered statistically significant.
Results: Fifty-five robotic colectomies were matched with 55 laparoscopic counterparts based on type of operation: right colectomy (n=28), sigmoidectomy (n=46), low anterior resection (n=26), proctocolectomy (n=4), transverse colectomy (n=2), abdominoperineal resection (n=2), and total abdominal colectomy (n=2). Robotic and laparoscopic colectomies had no significant difference in mean age (63.6 vs 62.5, p = 0.75), mean BMI (27.8 vs 27.5, p = 0.85), mean ASA score (2.5 vs 2.7, p = 0.17), or mean number of risk factors (0.95 vs 1.00, p = 0.80). While mean length of operation in minutes was similar (229 vs 218, p = 0.50), robotic cases had significantly lower conversion rate (0% vs 9.1%, p = 0.02). Overall postoperative complication rate (36.4% vs 45.5%, p = 0.33), gastrointestinal complication rate (29.1% vs 34.6%, p = 0.54), mean postoperative stay in days (9.2 vs 9.4, p = 0.93), and 30 day readmissions (12.7% vs 9.1%, p = 0.54) were also similar.
Conlusion: Our early experience with robotic colorectal surgery reveals lower conversion rate but similar short-term outcomes compared to the laparoscopic approach. Further advantages of robotic surgery may become apparent in experienced hands.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88263
Program Number: P790
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster