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Robotic versus laparoscopic right colectomy for colon cancer: a nationwide cohort study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

On a national level, the minimally invasive approach is widely adopted in Denmark. The adoption of robotic colorectal surgery is increasing; however, the advantage of a robotic approach in right colectomy is still uncertain. The purpose of this study was to compare robotic right colectomy with laparoscopic right colectomy on a national level.

Methods

This was a nationwide database study based on data from the Danish Colorectal Cancer Group database. Patients from all colorectal centers in Denmark in the period 2014–2018 treated with curative intend in an elective setting with either robotic or laparoscopic right colectomy were identified. Propensity score matching was performed to adjust for confounding, and the groups were compared on demographics, disease characteristics, operative data, and postoperative and pathology outcomes. Reporting was done in accordance with the STROBE statement.

Results

In total, 4002 patients were available for analysis. Propensity score matching in ratio 2:1 identified 718 laparoscopic and 359 robotic cases. After matching, we found a higher lymph node yield in the robotic group compared to the laparoscopic group, (32.5 vs. 28.4, P < 0.001), while radicality, plane of dissection, and pathological disease stages showed no differences. There were no statistical differences in morbidity and mortality. Intracorporeal anastomosis (23.7% vs. 4.5%, P < 0.001) was more commonly performed with a robotic approach.

Conclusions

Robotic approach was associated with a significant higher lymph node yield and with similar postoperative morbidity compared to a laparoscopic approach for right colectomy.

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Availability of data and code

Researchers who provide a methodologically sound proposal will be able to attain the deidentified individual participant data that underlie the results reported in the final article (text and tables).

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Acknowledgements

The authors are indebted to the Danish Colorectal Cancer Group (DCCG) for providing the data.

Funding

The study was funded by unrestricted grants from the Louis-Hansen Foundation, Jacob and Olga Madsen’s foundation, Trigon Foundation, Toyota-foundation, Dagmar Marshalls Foundation, Vissing foundation, The Kjaer Foundation, and the Nyegaard foundation.

Author information

Authors and Affiliations

  1. Department of Surgery, Herlev University Hospital, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark

    Niclas Dohrn & Mads Falk Klein

  2. Center for Surgical Science, Zealand University Hospital, Lykkebækvej 1, DK-4600, Koege, Denmark

    Niclas Dohrn & Ismail Gögenur

Authors
  1. Niclas Dohrn
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  2. Mads Falk Klein
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  3. Ismail Gögenur
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Niclas Dohrn and Mads Falk Klein. Interpreting the data was performed all authors. The first draft of the manuscript was written by Niclas Dohrn, and all authors commented on and critically revised previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Niclas Dohrn.

Ethics declarations

Ethics approval

By Danish law and the national ethics guidelines, approval was not required because the study was a database study. Approval from the Danish Agency for Data Protection and the scientific review board at the Danish Colorectal Cancer Group Database were acquired.

Consent to participate

Informed consent from participants were not needed as the study was a database study.

Conflict of interest

The authors declare no competing interests.

Disclaimer

The study was initiated by the investigators, and the funding organizations did not play any role in the study design, data collection, analysis or interpretation of the data, decision to publish, or preparation of the manuscript.

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Dohrn, N., Klein, M.F. & Gögenur, I. Robotic versus laparoscopic right colectomy for colon cancer: a nationwide cohort study. Int J Colorectal Dis 36, 2147–2158 (2021). https://doi.org/10.1007/s00384-021-03966-y

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