Short- and long-term outcomes of totally robotic versus robotic-assisted right hemicolectomy for colon cancer A retrospective study

Totally robotic right hemicolectomy (TRRH) is a novel alternative surgical method used for the treatment of colon cancer. The aim of this study was to compare both the short-and long-term outcomes of TRRH and robotic-assisted right hemicolectomy (RARH) for the treatment of colon cancer. We performed a 1: 2 matched propensity score analysis. We then retrospectively analyzed all procedures (64 cases TRRH and 128 cases RARH) carried out by a single surgeon between December 4, 2014 and June 20, 2018 at a large center. Both short-and long-term surgical outcomes were compared between 2 different groups. Based on the propensity score matching, we selected 64 patients that had undergone TRRH treatment and 128 patients who had undergone RARH treatment. The preoperative clinical-pathological characteristics were well matched between the 2 groups. We observed no significant differences between the 2 groups in postoperative pathological outcomes. The mean operative time was found to be significantly longer in the TRRH group compared to the RARH group (168.2 +/- 9.1 minutes vs 153.4 +/- 7.4 minutes, P=.034). The mean operative incision length was found to be significantly longer in the TRRH group than in the RARH group (4.5 +/- 0.6 cm vs 6.9 +/- 1.1 cm, P=.023). Postoperative pain score (visual analog scale at day 1) was found to be significantly lower in the TRRH group than in the RARH group (2.9 +/- 1.3 vs 4.1 +/- 2.1, P=.005). The time to pass flatus was observed to be statistically lower in the TRRH group (P=.042). We observed 3 twists of mesentery in the RARH group, while none were observed in the TRRH group (P<.050). Both the 3-year overall survival (TRRH [91.6%] vs RARH [89.2%], P=.467) and the 3-year disease-free survival (TRRH [81.4%] vs RARH [78.2%], P=.551) were determined to be comparable between the 2 groups studied here. We show that TRRH is a safe and feasible treatment option for colon cancer patients in terms of both short-and long-term outcomes. High-volume, randomized, controlled trials with sufficient follow-up studies will need to be carried out in order to confirm this rationale.