Robotic versus conventional laparoscopic technique for the treatment of colorectal cancer disease
Abstract
Background: Robotic surgery addresses many of the technical and ergonomic limitations of laparoscopic surgery, but the literature regarding clinical outcomes in colorectal surgery is limited. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience.
Methods: In our study we analyzed and compared two group of patients operated robotically and laparoscopically. 85 patients operated robotically (49% female, 51% male). The average age was 63.5 years, 110 patients operated laparoscopic operations (64% male, 36% female), the average age was 65.5 years.
Results: In all patients radical resection has been done. The average number of isolated lymph nodes in the robotic method was 19 while in laparoscopic method was 15,5. The hospitalization was shorter in robotic operated patients (average 7,3days), on the other hand the time of the robotic operations was longer than laparoscopic operations. Intraoperative blood loss was in the robotic method smaller (50-120 ml) in comparison with laparoscopic method (100-300 ml). Conversion to open surgery was in robotic method lower (4,5%) than in laparoscopic method (7%). Laparoscopic method has more frequent complications 9 (10,3%) while robotic method 4 (9%). In 10 years follow up 9 laparoscopically operated died (10,3%), (5 due to cardiovascular disease, 4 due to progression of disease). In this period 3 robotically operated patients died (6%), one due to progression of disease, the others due to cardiovascular disease. The most common operation was right hemicolectomy (46%) by laparoscopic procedure, in the robotic method was anterior resection of rectum (54%).
Conclusion: Robotic colorectal surgery (RCS) is a promising technique and is safe and effective alternative to laparoscopic colorectal surgery. The advantages of RCS include reduced EBLs, lower conversion rates and shorter times to recovery of bowel function. Further studies are required to define the financial effects of RCS and the effects of RCS on long-term oncologic outcomes.
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