{Reference Type}: Journal Article
{Title}: Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score-matched analysis.
{Author}: de'Angelis N;Schena CA;Espin-Basany E;Piccoli M;Alfieri S;Aisoni F;Coccolini F;Frontali A;Kraft M;Lakkis Z;Le Roy B;Luzzi AP;Milone M;Pattacini GC;Pellino G;Petri R;Piozzi GN;Quero G;Ris F;Winter DC;Khan J; ;
{Journal}: Colorectal Dis
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 8
{Factor}: 3.917
{DOI}: 10.1111/codi.17089
{Abstract}: <B>OBJECTIVE: </B>Minimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking.<BR><B>METHODS: </B>This was a multicentre propensity score-matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra- and postoperative complication rates, overall (OS), and disease-free survival (DFS).<BR><B>RESULTS: </B>Among a total of 200 patients, 39 RRC were compared with 78 PS-matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1-, 3- and 5-year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC.<BR><B>CONCLUSIONS: </B>Adequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short-term postoperative outcomes.