Skip to main content

Advertisement

Log in

Right colectomy: consecutive 100 patients treated with laparoscopic and robotic technique for malignancy. Cumulative experience in a single centre

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Robotic-assisted resections prove beneficial in overcoming potential limitation of laparoscopy, but clear evidences on patient’s benefits are still lacking. We report our experience on 100 consecutive patients who underwent right colectomy with either robotic or laparoscopic approaches. Data were prospectively collected on a dedicated database (ASA score, age, operative time, conversion rate, re-operation rate, early complications, length of stay, and pathological results). Median total operative time was 160 min in LS group (IQR = 140–180) and 204 min for RS group (IQR = 180–230). Median time to first flatus was 2.5 days for LS group (IQR = 2 - 3) and 2 days for RS group (IQR = 1–2). Length of stay (median) was 8 days in LS group (IQR = 6–10) and 5 days in RS group (IQR = 5–7). No statistically significant difference was found between the 2 groups when the number of harvested nodes, the anastomotic leakage and the postoperative bleeding were analyzed. The 30-day mortality was 0% in LS and RS groups. Conversion rate for LS group was 14% (7/50 pts) and for RS group was 0% (0/50). Minimally invasive surgery is a feasible and safe technique. The RS may overcome some technical limitations of laparoscopic surgery and it achieves the same oncological results compared to LS but with higher costs. The lower conversion rate allows to expect better clinical outcomes and lower complication rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229

    Article  Google Scholar 

  2. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol 25(21):3061–3068

    Article  PubMed  Google Scholar 

  3. Poulin EC, Mamazza J, Schlachta CM, Grégoire R, Roy N (1999) Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma. Ann Surg 229(4):487–492

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M (2003) Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 17:636–640. https://doi.org/10.1007/s00464-002-8516-4

    Article  CAS  PubMed  Google Scholar 

  5. Kaiser AM, Kang JC, Chan LS, Vukasin P, Beart RW Jr. (2004) Laparoscopic-assisted vs. open colectomy for colon cancer: a prospective randomized trial. J Laparoendosc Adv Surg Tech 14(6):329–334

    Article  Google Scholar 

  6. Champault GG, Barrat C, Raselli R, Elizalde A, Catheline JM (2002) Laparoscopic versus open surgery for colorectal carcinoma: a prospective clinical trial involving 157 cases with a mean follow-up of 5 years. Surg Laparosc Endosc Percutan Tech. 12(2):88–95

    Article  PubMed  Google Scholar 

  7. Delgado S, Lacy AM, Filella X, Castells A, García-Valdecasas JC, Pique JM, Momblán D, Visa J (2001) Acute phase response in laparoscopic and open colectomy in colon cancer. Randomized Study. Dis Colon Rectum. 44(5):638–646

    Article  CAS  PubMed  Google Scholar 

  8. Hu JK, Zhou ZG, Chen ZX, Wang LL, Yu YY, Liu J, Zhang B, Li L, Shu Y, Chen JP (2003) Comparative evaluation of immune response after laparoscopical and open total mesorectal excisions with anal sphincter preservation in patients with rectal cancer. World J Gastroenterol 9(12):2690–2694

    Article  PubMed  PubMed Central  Google Scholar 

  9. Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G (2002) Clinical Outcomes of Surgical Therapy (COST) Study Group. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 287:321–328

    Article  PubMed  Google Scholar 

  10. Nelson H, Sargent D, Wieand HS et al (2004) The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059

    Article  CAS  PubMed  Google Scholar 

  11. Weber PA, Merola S, Wasielewski A, Ballantyne GH (2002) Tele-robotic assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 45:1689–1694

    Article  PubMed  Google Scholar 

  12. Cadiere GB, Himpens J, Germay O et al (2001) Feasibility of robotic laparoscopic surgery: 146 cases. World J Surg 25:1467–1477

    CAS  PubMed  Google Scholar 

  13. Baik SH, Ko YT, Kang CM et al (2008) Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc 22(7):1601–1608. https://doi.org/10.1007/s00464-008-9752-z (Epub 2008 Feb 13)

    Article  CAS  PubMed  Google Scholar 

  14. Ballantyne GH (2002) Robotic surgery, telerobotic surgery, telepresence, and telementoring. Review of early clinical results. Surg Endosc 16(10):1389–1402 (Epub 2002 Jul 29)

    Article  CAS  PubMed  Google Scholar 

  15. D’Annibale A, Pernazza G, Pende V, Monsellato I (2010) Minimally invasive robot. In: Baik SH (ed) Assisted colorectal resections robot surgery. INTECH

  16. Giulianotti PC, Coratti A, Angelini M et al (2003) Robotics in general surgery: personal experience in a large community hospital. Arch Surg 138:777–784

    Article  PubMed  Google Scholar 

  17. Rondelli F, Balzarotti R, Villa F, Guerra A, Avenia N, Mariani E, Bugiantella W (2015) Is robot-assisted laparoscopic right colectomy more effective than the conventional laparoscopic procedure? A meta-analysis of short-term outcomes. Int J Surg. 2015(18):75–82. https://doi.org/10.1016/j.ijsu.2015.04.044

    Article  Google Scholar 

  18. Trastulli S, Coratti A, Guarino S et al (2015) Robotic right colectomy with intracorporeal anastomosis compared with laparoscopic right colectomy with extracorporeal and intracorporeal anastomosis: a retrospective multicentre study. Surg Endosc 29(6):1512–1521. https://doi.org/10.1007/s00464-014-3835-9

    Article  PubMed  Google Scholar 

  19. Woeste G, Bechstein WO, Wullstein C (2005) Does telerobotic assistance improve laparoscopic colorectal surgery? Int J Colorectal Dis 20:253–257

    Article  PubMed  Google Scholar 

  20. Munz Y, Moorthy K, Kudchadkar R et al (2004) Robotic assisted rectopexy. Am J Surg 187:88–92

    Article  PubMed  Google Scholar 

  21. Rockall TA, Darzi A (2003) Robot-assisted laparoscopic colorectal surgery. Surg Clin North Am 83(6):1463–1468

    Article  PubMed  Google Scholar 

  22. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Colorectal Dis 11(4):354–364 (discussion 364–355)

    Article  CAS  PubMed  Google Scholar 

  23. Formisano G, Misitano P, Giuliani G, Calamati G, Salvischiani L, Bianchi PP (2016) Laparoscopic versus robotic right colectomy: technique and outcomes. Updates Surg 68(1):63–69. https://doi.org/10.1007/s13304-016-0353-4 (Epub 2016 Mar 18)

    Article  PubMed  Google Scholar 

  24. Spinoglio G, Marano A, Bianchi PP, Priora F, Lenti LM, Ravazzoni F, Formisano G (2016) Robotic right colectomy with modified complete mesocolic excision: long-term oncologic outcomes. Ann Surg Oncol. 23(Suppl 5):684–691. https://doi.org/10.1245/s10434-016-5580x (Epub 2016 Oct 3)

    Article  PubMed  Google Scholar 

  25. Ozben V, Baca B, Atasoy D, Bayraktar O, Aghayeva A, Cengiz TB, Erguner I, Karahasanoglu T, Hamzaoglu I (2016) Robotic complete mesocolic excision for right-sided colon cancer. Surg Endosc. 30(10):4624–4625. https://doi.org/10.1007/s00464-016-4786-0 (Epub 2016 Feb 22)

    Article  PubMed  Google Scholar 

  26. D’Annibale A, Pernazza G, Morpurgo E et al (2010) Robotic right resection: evaluation of First 50 consecutive cases for malignant disease. Ann Surg Oncol 17(11):2856–2862. https://doi.org/10.1245/s10434-010-1175-0

    Article  PubMed  Google Scholar 

  27. Miller PE, Dao H, Paluvoi N, Bailey M, Margolin D, Shah N, Vargas D (2016) Comparison of 30-day postoperative outcomes after laparoscopic vs robotic colectomy. J Am Coll Surg. https://doi.org/10.1016/j.jamcollsurg.2016.03.041

    Article  PubMed  Google Scholar 

  28. Tong DKH, Law WL (2007) Laparoscopic versus open right hemicolectomy for carcinoma of the colon. JSLS 11:76–80

    PubMed  PubMed Central  Google Scholar 

  29. Moghadamyeghaneh Z, Masoomi H, Mills SD et al (2014) Outcomes of conversion of laparoscopic colorectal surgery to open surgery. JSLS 18(4):e2014.0023010

    Article  Google Scholar 

  30. Solaini L, Bazzocchi F, Cavaliere D, Avanzolini A, Cucchetti A, Ercolani G (2018) Robotic versus laparoscopic right colectomy: an updated systematic review and meta-analysis. Surg Endoc 2(3):1104–1110. https://doi.org/10.1007/s00464-017-5980-4 (Epub 2017 Dec 7)

    Article  Google Scholar 

  31. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 240(2):205–213

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. L. Mégevand.

Ethics declarations

Conflict of interest

The Authors have no conflicts of interest or financial ties to disclose.

Research involving human participants and/or animals

We declare that the study has been conducted according to GCP and ethical standards with no adoption of human or animal source of experimental investigation. This is a retrospective study.

Informed consent

Informed consent was obtained by all patients as per local protocol.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mégevand, J.L., Amboldi, M., Lillo, E. et al. Right colectomy: consecutive 100 patients treated with laparoscopic and robotic technique for malignancy. Cumulative experience in a single centre. Updates Surg 71, 151–156 (2019). https://doi.org/10.1007/s13304-018-0599-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-018-0599-0

Keywords

Navigation