Robotic-assisted and laparoscopic sigmoid resection

Abstract

Background and Objectives: Published comparisons of minimally invasive approaches to colon surgery are lim-ited. The objective of the current study is to compare the effectiveness of robotic-assisted and laparoscopic sigmoid resection. Methods: A multicenter retrospective comparative analysis of perioperative outcomes from consecutive robotic-assisted and laparoscopic sigmoid resections performed between 2010 and 2015 by six general and colorectal surgeons, who are experienced in both robotic-assisted and laparoscopic surgical techniques and who had <50 annual case volumes for each approach. Baseline characteristics and surgical risk factors between the two groups were balanced using a propensity score methodology with inverse probability of treatment weighting. Mean standardized differences were reported, and in all in-stances, a p-value = 0.05 was considered statistically sig-nificant. Results: Three hundred thirty-six cases (robotic-assisted, n>211; laparoscopic, n > 125) met eligibility criteria and were included in the study. Following weighting, patient demographics and baseline characteristics were compara-ble between the robotic-assisted (n > 344) and laparoscopic (n > 349) groups. The laparoscopic group was associated with shorter operating room and surgical times. The robotic-assisted group had lower estimated blood loss and shorter time to first flatus compared to the laparoscopic group. Rates of complications post discharge to 30 d tended to be lower for the RA group: 5.1% vs 8.6% [p > 0.0657]. The RA group also had lower rates of read-missions and reoperations: 4% vs 8% [p > 0.029] and 0.5% vs 5.1% [p > 0.0003], respectively. Conclusions: Robotic-assisted sigmoid colon resection is clinically effective and provides a minimally invasive al-ternative to the laparoscopic approach with improved intraoperative and postoperative outcomes for colorectal patients.