Comparison of clinical efficacy of robotic right colectomy and laparoscopic right colectomy for right colon tumor

Zhu, Quan; Xu, Xin; Pan, Zhi Jian

doi:10.1097/md.0000000000027002

Cited by 12 publications

(13 citation statements)

References 21 publications

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“…The study concluded that RRC was associated with a greater number of harvested lymph nodes (weighted MD [WMD] 1.47; P = 0.05), reduced blood loss (WMD -13.43; P = 0.0003), lower rate of conversion to open surgery (OR 0.30; P < 0.0001), but with a higher operative duration (WMD 65.20; P < 0.00001) when compared to LRC. No major differences were observed between the two approaches regarding bowel function recovery, length of hospitalization, reoperation rates, complication rates, mortality rates, wound infection, and anastomotic leakage [18].…”

Section: Literature Reviewmentioning

confidence: 88%

Precision Versus Practicality: A Comprehensive Analysis of Robotic Right Colectomy Versus Laparoscopic Right Colectomy, Future Directions, Biases, Research Gaps, and Their Implications

Kossenas,

Karamatzanis,

Moutzouri

et al. 2024

Cureus

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Colorectal cancer is the third most commonly diagnosed cancer in the world and second in cancer-related mortality. It is most prevalent in the developed world and is often associated with lifestyle factors along with age and genetics. The inclusion criteria comprised high-level evidence, such as randomized clinical trials, meta-analyses, and systematic reviews, conducted between 2012 and 2023, that directly compared the two approaches. The review reveals mixed outcomes between robotic right colectomy (RRC) and laparoscopic right colectomy (LRC). The robotic approach was associated with longer operative duration and higher costs but with decreased blood loss and quicker recovery compared to laparoscopy. On the other hand, no major differences were observed regarding lymph node retrieval, duration of hospitalization, and surgical complications. Regarding future directions, it is evident that the focus needs to shift beyond the operative parameters and to patient-centered outcomes, which are underreported. Also, more randomized clinical trials are required, focusing on safety, efficacy, and long-term quality of life. Costs-benefit analyses are required to weigh the benefits of robotic surgery against the implementation and practice costs. Additionally, improvements in surgeons' training may be necessary to reduce the operative duration and potentially decrease operational costs. Finally, standardization of research protocols may be necessary to reduce biases.

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Section: Literature Reviewmentioning

confidence: 88%

Precision Versus Practicality: A Comprehensive Analysis of Robotic Right Colectomy Versus Laparoscopic Right Colectomy, Future Directions, Biases, Research Gaps, and Their Implications

Kossenas,

Karamatzanis,

Moutzouri

et al. 2024

Cureus

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“…Recent meta-analyses published in 2021 by Zhu et al. [ 11 ] and Kowalewski et al. [ 12 ] and in 2019 by Rausa et al.…”

Section: Discussionmentioning

confidence: 99%

“…[ 15 ]. All authors highlighted the significantly higher costs of the robotic procedure in comparison to laparoscopic surgery [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ]. Interestingly, only one department in the current study stated that they stopped robotic surgery due to higher costs.…”

Section: Discussionmentioning

confidence: 99%

The distribution of robotic surgery in general and visceral surgery departments in Switzerland – a nationwide inquiry

Stalder,

Mazzola,

Adamina

et al. 2024

Innovative Surgical Sciences

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Objectives Since its introduction as a clinical technique, robotic surgery has been extended to different fields of surgery. However, the indications as well as the number of robotic procedures varied in different institutions. The aim of this investigation was to evaluate the current use of robotic surgery in general and digestive surgery in Switzerland. Methods All Swiss surgical departments that are recognized training institutes for postgraduate training in surgery by the Swiss Institute of Medical Education (SIWF) were queried with a detailed questionnaire regarding the use of robotic surgery techniques and were analyzed regarding hospital size and type of hospital. Results Ninety-three departments were queried, and 67 % (n=63) answered the survey. Fifty-eight were public, and five were private institutions. Seventeen (26 %) of the queried departments used robotic surgery in digestive surgery. Four out of 17 (23 %) of the departments that performed robotic surgery were private hospitals, while 13 (77 %) were public institutions. In the majority of departments, robotic surgery of the rectum (n=12; 70.6 %) and colon (n=11; 64.7 %) was performed, followed by hernia procedures (n=8; 47.1 %) and fundoplication (n=7; 41.2 %). Less frequently, pancreatic resections (n=5; 29.4 %), cholecystectomy (n=4; 23.5 %), adrenalectomy (n=4; 23.5 %), gastric bypass (n=3; 17.7 %), gastric sleeve (n=3; 17.7 %), hepatic procedures (n=2; 11.7 %), or small bowel resections (n=1; 5.9 %) were performed as robotic procedures. More than 25 procedures per year per department were performed for hernia surgery (n=5 departments), gastric bypass (n=2 departments), cholecystectomy, fundoplication, and colon surgery (each n=1 department). Conclusions The number and range of robotic procedures performed in Switzerland varied widely. Higher accreditation for general surgery or subspecialization of visceral surgery of the department was positively associated with the use of robotic techniques, reflecting an unequal availability of robotic surgery.

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“…Despite this, laparoscopy is considered the standard of care for right-sided colonic cancer resection [18][19][20], and the implementation of robotic surgery is underway [21,22]. These MIS approaches are technically more demanding, especially if the ileocolonic anastomosis is performed intracorporeally, but widespread evidence supports that the surgical outcomes are improved compared to open surgery [12,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

“…Despite this, laparoscopy is considered the standard of care for right‐sided colonic cancer resection [18–20], and the implementation of robotic surgery is underway [21, 22]. These MIS approaches are technically more demanding, especially if the ileocolonic anastomosis is performed intracorporeally, but widespread evidence supports that the surgical outcomes are improved compared to open surgery [12, 23–25]. Recently, Sweigert et al [26] compared prolonged minimally‐invasive (laparoscopic and robotic) right colectomies (having an operation duration between 165 and 319 min) with shorter open procedures (97–164 min), and showed that, despite the longer OT, MIS was associated with lower overall morbidity rate, anastomotic leak, surgical site infections and shorter hospital stay, confirming that the benefits of MIS were maintained also in long‐lasting procedures.…”

Section: Introductionmentioning

confidence: 99%

Impact of operation duration on postoperative outcomes of minimally‐invasive right colectomy

de’Angelis

Schena

Piccoli³

et al. 2022

Colorectal Disease

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Aim: Operation time (OT) is a key operational factor influencing surgical outcomes. The present study aimed to analyse whether OT impacts on short-term outcomes of minimally-invasive right colectomies by assessing the role of surgical approach (robotic [RRC] or laparoscopic right colectomy [LRC]), and type of ileocolic anastomosis (i.e., intracorporal [IA] or extra-corporal anastomosis [EA]). Methods: This was a retrospective analysis of the Minimally-invasivE surgery for oncological Right ColectomY (MERCY) Study Group database, which included adult patients with nonmetastatic right colon adenocarcinoma operated on by oncological RRC or LRC between January 2014 and December 2020. Univariate and multivariate analyses were used. Results:The study sample was composed of 1549 patients who were divided into three groups according to the OT quartiles: (1) First quartile, <135 min (n = 386); (2) Second and third quartiles, 135-199 min (n = 731); and (3) Fourth quartile ≥200 min (n = 432). The majority (62.7%) were LRC-EA, followed by LRC-IA (24.3%), RRC-IA (11.1%), and RRC-EA (1.9%). Independent predictors of an OT ≥ 200 min included male gender, age, obesity, diabetes, use of indocyanine green fluorescence, and IA confection. An OT ≥ 200 min was significantly associated with an increased risk of postoperative noninfective complications (AOR: 1.56; 95% CI: 1.15-2.13; p = 0.004), whereas the surgical approach and the type of anastomosis had no impact on postoperative morbidity. Conclusion:Prolonged OT is independently associated with increased odds of postoperative noninfective complications in oncological minimally-invasive right colectomy.

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Comparison of clinical efficacy of robotic right colectomy and laparoscopic right colectomy for right colon tumor

Cited by 12 publications

References 21 publications

Precision Versus Practicality: A Comprehensive Analysis of Robotic Right Colectomy Versus Laparoscopic Right Colectomy, Future Directions, Biases, Research Gaps, and Their Implications

Precision Versus Practicality: A Comprehensive Analysis of Robotic Right Colectomy Versus Laparoscopic Right Colectomy, Future Directions, Biases, Research Gaps, and Their Implications

The distribution of robotic surgery in general and visceral surgery departments in Switzerland – a nationwide inquiry

Impact of operation duration on postoperative outcomes of minimally‐invasive right colectomy

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