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Oncological outcomes of open, laparoscopic and robotic colectomy in patients with transverse colon cancer

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Abstract

Background

Literature concerning surgical management of transverse colon cancer is scarce, since many key trials excluded transverse colon cancer. The aim of this study was to evaluate clinical and oncological outcomes comparing open, laparoscopic and robotic transverse colon cancer resection.

Methods

Consecutive patients who underwent elective surgery for transverse colon cancer between December 2005 and July 2021 were included. Data were kept in a prospective database approved by the institutional ethics committee. Primary outcome was overall and disease-free survival. Secondary outcomes included complications, operative time, length of stay and lymph node harvest. Statistical analysis was corrected for age and tumour localisation.

Results

Two hundred and forty-six (38 robotic, 71 open and 137 laparoscopic resections) were recruited in this study. There were five conversions during laparoscopic procedures. Operative time was significantly shorter in robotic vs laparoscopic procedures (195 vs 238 min, p = 0.005) and length of stay was shorter in robotic vs laparoscopic and open group (7 vs 9 vs 15 days, p < 0.001). There was no difference in overall complications. R0 resections were similar. Lymph node harvest was highest in the robotic group vs. laparoscopic or open (32 vs. 29 vs. 21, p < 0.001). Overall survival was 97%, 85% and 60% (p < 0.001) and disease-free survival was 91%, 78% and 56% (p < 0.001) for the robotic, laparoscopic and open groups, respectively.

Conclusions

Minimally invasive surgery for transverse colon cancer is safe and offers good clinical and oncological outcomes. Robotic resection is associated with significantly shorter operating times, higher lymph node harvest, lower conversion rate and does not increase morbidity. Differences in disease-free and overall survival should be further explored in randomised controlled trials.

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Acknowledgements

The authors would like to thank Karen Flashman, for her work as data coordinator at PHU NHS Trust.

Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Queen Alexandra Hospital, Southwick Hill Road, Cosham, Portsmouth, PO6 3LY, UK

    V. Maertens, S. Stefan, M. Rutgers, N. Siddiqi & J. S. Khan

  2. Department of General and Abdominal Surgery, AZ Sint Lucas, Ghent, Belgium

    V. Maertens

  3. University Hospitals Dorset, Poole, UK

    N. Siddiqi

  4. Faculty of Sciences, School of Health Sciences, Social Work, Anglia Ruskin University Chelmsford, Cambridge, UK

    J. S. Khan

  5. Faculty of Health & Social Care, University of Portsmouth, Portsmouth, UK

    J. S. Khan

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Contributions

All the authors contributed to the study concept and design. VM and Samuel Stefan did literature study on transverse colon surgery and were major contributors in writing the manuscript. MR, MN and NS performed data collection and analysed and interpreted the patient data regarding the outcomes after surgery. VM and JK wrote the discussion. The first draft of the manuscript was written by VM and all the authors commented on previous versions of the manuscript. All the authors read and approved the final manuscript.

Corresponding author

Correspondence to J. S. Khan.

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Conflict of interest

Prof Jim Khan declares to be a surgeon proctor with Intuitive Surgical. The authors have no financial or non-financial interests.

Availability of data and materials

All data generated or analysed during this study are included in this published article.

Ethics approval

This research study was conducted retrospectively from data obtained for clinical purposes kept in an ethics approved database by the Portsmouth Hospitals University NHS Trust, UK.

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Consent for participation was obtained from all the included participants.

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Consent for publication was obtained from all the included participants.

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Maertens, V., Stefan, S., Rutgers, M. et al. Oncological outcomes of open, laparoscopic and robotic colectomy in patients with transverse colon cancer. Tech Coloproctol 26, 821–830 (2022). https://doi.org/10.1007/s10151-022-02650-9

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  • DOI: https://doi.org/10.1007/s10151-022-02650-9

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