RT Journal Article
SR Electronic
T1 Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity
JF Canadian Journal of Surgery
JO CAN J SURG
FD Canadian Medical Association
SP 262
OP 267
DO 10.1503/cjs.016615
VO 59
IS 4
A1 Feinberg, Adina E.
A1 Elnahas, Ahmad
A1 Bashir, Shaheena
A1 Cleghorn, Michelle C.
A1 Quereshy, Fayez A.
YR 2016
UL http://canjsurg.ca/content/59/4/262.abstract
AB Background: Robotic surgery has emerged as a minimally invasive alternative to traditional laparoscopy. Robotic surgery addresses many of the technical and ergonomic limitations of laparoscopic surgery, but the literature regarding clinical outcomes in colorectal surgery is limited. We sought to compare robotic and laparoscopic colorectal resections with respect to 30-day perioperative outcomes.Methods: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients who underwent robotic or laparoscopic colorectal surgery in 2013. We performed a logistic regression analysis to compare intraoperative variables and 30-day outcomes.Results: There were 8392 patients who underwent laparoscopic colorectal surgery and 472 patients who underwent robotic colorectal surgery. The robotic cohort had a lower incidence of unplanned intraoperative conversion (9.5% v. 13.7%, p = 0.008). There were no significant differences between robotic and laparoscopic surgery with respect to other intraoperative and postoperative outcomes, such as operative duration, length of stay, postoperative ileus, anastomotic leak, venous thromboembolism, wound infection, cardiac complications and pulmonary complications. On multivariable analysis, robotic surgery was protective for unplanned conversion, while male sex, malignancy, Crohn disease and diverticular disease were all associated with open conversion.Conclusion: Robotic colorectal surgery has comparable 30-day perioperative morbidity to laparoscopic surgery and may decrease the rate of intraoperative conversion in select patients.