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Propensity score-matched analysis comparing laparoscopic to robotic surgery for colorectal cancer shows comparable clinical and oncological outcomes

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Abstract

Robotic colorectal surgery is gaining popularity. The objective of this study was to compare clinical and cancer outcomes in propensity-score matched cohorts (PSM-1:1) undergoing colorectal cancer (CRC) surgery performed using laparoscopic or robotic surgery in a single institution. A PSM cohort comparison was performed in a tertiary referral cancer and National accredited rectal cancer surgery centre. Patients with CRC undergoing laparoscopic or robotic resection with curative intent from 2016 to 2019 (inclusive) were assessed for inclusion. Matched cohorts were selected using a 1:1 ratio. Statistical analysis was performed using SPSS, version 22. 128 patients were analysed [laparoscopic (n = 64); robotic (n = 64)]. Median age was 64 years (29–84 years). 55% (n = 70) of patients were male, 45% female (n = 58). SSI rates were slightly lower in the robotic group [10.9% (n = 7) v 12.5% (n = 8) p = 0.40]. Anastomotic leak rates were equal in both groups [5.4% (n = 3)]. All but one patient received an R0 resection in each group, median LNY was 14 in the robotic group and 12 in the laparoscopic group (p = 0.004) and no difference in disease recurrence (p = 0.465) or survival (p = 0.886) was observed. Structured introduction of a robotic colorectal programme over a 3-year period has resulted in equivalent outcomes with an established laparoscopic programme for CRC.

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Acknowledgements

I would like to thank all members of the laparoscopic and robotic-assisted surgery programmes at University Hospital Limerick for their contribution to the clinical practice upon which this research was based.

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Authors and Affiliations

  1. Department of Colorectal Surgery, University Hospital Limerick, Limerick, Ireland

    Christina A. Fleming, Muhamad Fahad Ullah, Kah Hoong Chang, Emma McNamara, Eoghan Condon, David Waldron, J. Calvin Coffey & Colin B. Peirce

  2. Robotic Assisted Surgery Programme, University Hospital Limerick, Limerick, Ireland

    Christina A. Fleming, Muhamad Fahad Ullah, Kah Hoong Chang, Emma McNamara, Eoghan Condon, J. Calvin Coffey & Colin B. Peirce

  3. Graduate Entry Medical School, University of Limerick, Limerick, Ireland

    J. Calvin Coffey & Colin B. Peirce

  4. Centre for Interventions in Infection, Inflammation and Immunity [4i], University of Limerick, Limerick, Ireland

    J. Calvin Coffey

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  1. Christina A. Fleming
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  2. Muhamad Fahad Ullah
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  3. Kah Hoong Chang
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  4. Emma McNamara
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  7. J. Calvin Coffey
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  8. Colin B. Peirce
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Correspondence to Christina A. Fleming.

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Conflict of interest

Christina A Fleming, Muhammad F Ullah, Kah Hoong Chang, Emma McNamara, David Waldron, Eoghan Condon, J Calvin Coffey, Colin Peirce declares that s/he has no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Informed consent was obtained from all patients for being included in the study.

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Fleming, C.A., Ullah, M.F., Chang, K.H. et al. Propensity score-matched analysis comparing laparoscopic to robotic surgery for colorectal cancer shows comparable clinical and oncological outcomes. J Robotic Surg 15, 389–396 (2021). https://doi.org/10.1007/s11701-020-01116-0

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  • DOI: https://doi.org/10.1007/s11701-020-01116-0

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