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Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

A Correction to this article was published on 25 February 2019

This article has been updated

Abstract

Background

During the past decade, the concept of complete mesocolic excision (CME) has emerged as a possible strategy to minimize recurrence for right colon cancers. The purpose of this study was to compare robotic versus laparoscopic CME in performing right colectomy for cancer.

Methods

Pertinent data of all patients who underwent robotic or laparoscopic right colectomy with CME using a Pfannenstiel incision and intracorporeal anastomosis performed between October 2005 and November 2015 were entered in a prospectively maintained database.

Results

A total of 202 patients underwent robotic (n = 101) or laparoscopic (n = 101) right colectomy within the study period. Patient characteristics were equivalent between groups. The robotic group showed a statistically significant reduction in conversion rate (0% vs. 6.9%, p = 0.01) but a longer operative time (279 min vs. 236 min, p < 0.001) compared with the laparoscopic group. There were no other differences in perioperative clinical or pathological outcomes. Five-years overall survival was 77 versus 73 months for the robotic versus laparoscopic groups (p = 0.64). The disease-free survival (DFS) rates were 85% and 83% for the robotic versus laparoscopic groups (p = 0.58). Among UICC stage III patients, there was a slight but not significant difference in 5-year DFS for the robotic group (81 vs. 68 months; p = 0.122).

Conclusions

Both approaches for right colectomy with CME were safe and feasible and resulted in excellent survival. Robotic assistance was beneficial for performing intracorporeal anastomosis and dissection as evidenced by the lower conversion rates. Further robotic experience may shorten the operative time.

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Change history

  • 25 February 2019

    Dario Ribero���s affiliation is corrected as reflected here.

  • 25 February 2019

    Dario Ribero���s affiliation is corrected as reflected here.

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Acknowledgment

The authors thank Dr. Carlo Di Pietrantonj (Senior Statistician, Regional Epidemiology Unit SeREMI, Local Health Unit, Alessandria, Italy) for his help with the statistical support.

Author information

Authors and Affiliations

  1. Division of Gastrointestinal Surgery, European Institute of Oncology, Milan, Italy

    Giuseppe Spinoglio MD, FACS, Wanda Petz MD, Simona Borin MD & Emilio Bertani MD

  2. Department of Surgery, Misericordia Hospital, Grosseto, Italy

    Paolo P. Bianchi MD, PhD & Giampaolo Formisano MD

  3. Department of General and Oncologic Surgery, SS Antonio and Biagio Hospital, Alessandria, Italy

    Alessandra Marano MD, Fabio Priora MD, Luca M. Lenti MD, PhD & Ferruccio Ravazzoni MD, PhD

  4. Department of Surgery, Candiolo Cancer Institute, Turin, Italy

    Dario Ribero MD

Authors
  1. Giuseppe Spinoglio MD, FACS
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  2. Paolo P. Bianchi MD, PhD
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  3. Alessandra Marano MD
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  4. Fabio Priora MD
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  5. Luca M. Lenti MD, PhD
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  6. Ferruccio Ravazzoni MD, PhD
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  7. Wanda Petz MD
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  8. Simona Borin MD
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  9. Dario Ribero MD
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  10. Giampaolo Formisano MD
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  11. Emilio Bertani MD
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Corresponding author

Correspondence to Emilio Bertani MD.

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Conflicts of interest and Source of Funding

Dr. Giuseppe Spinoglio is a proctor and speaker for Intuitive Surgical Inc. and he received a grant from Intuitive Surgical Inc. for a study outside the submitted work titled “Sentinel lymph node identification in colon cancer with robotic near-infrared (NIR) fluorescent imaging system.” Drs. Fabio Priora and Luca Matteo Lenti are proctors to Intuitive Surgical, Inc. For the remaining authors, no conflicts of interest were declared.

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Spinoglio, G., Bianchi, P.P., Marano, A. et al. Robotic Versus Laparoscopic Right Colectomy with Complete Mesocolic Excision for the Treatment of Colon Cancer: Perioperative Outcomes and 5-Year Survival in a Consecutive Series of 202 Patients. Ann Surg Oncol 25, 3580–3586 (2018). https://doi.org/10.1245/s10434-018-6752-7

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