Robotic-assisted ileocolic resection for Crohn's disease: outcomes from an early national experience

Crohn's disease is an incurable inflammatory disorder that can affect the entire gastrointestinal tract. While medical management is considered first-line treatment, approximately 70-90% of patients with Crohn's disease will require at least one surgical intervention during the course of their lifetimes. Traditionally, abdominal surgery for Crohn's disease has been performed via an open approach with an increasing adoption of minimally invasive techniques. The aim of this study was to evaluate and compare postoperative outcomes from an initial national experience with robotic-assisted ileocolic resection for Crohn's disease. Patients who underwent elective ileocolic resection for Crohn's disease by robotic-assisted or open approaches from 2011 to Q3 2015 were identified using ICD-9 codes from the Premier Healthcare Database. Propensity-score matching (1:1) was performed using age, gender, race, Charlson index score, and year of surgery to form comparable cohorts in order to compare the robotic-assisted and open groups. 3641 patients underwent elective ileocolic resection for Crohn's disease during the study period (1910 [52.5%] open and 109 [3%] robotic-assisted). Post-matched comparison of cohorts (n = 108 per cohort) showed that robotic-assisted cases were longer by a mean of 60 min (p < 0.0001), had shorter length of hospital stay by a median of 2 days (p < 0.001) and a lower 30-day complication rate (24% vs. 38%; p = 0.039). This national database assessment of patients undergoing elective ileocolic resection for Crohn's disease demonstrated that a robotic-assisted approach was associated with longer operative times, shorter length of hospital stay and lower 30-day complication rates compared to open approach.