Abstract
Background: The comparative outcomes of robotic versus laparoscopic colectomy for colon cancer remain uncertain in large patient series. We compared perioperative outcomes, conversion rates, and short-term oncologic results between these two minimally invasive approaches.
Methods: We retrospectively analyzed 450 consecutive patients undergoing elective colectomy for colon cancer at a single academic medical center between January 2019 and December 2024. Robotic colectomy (n=180) was compared to laparoscopic colectomy (n=270). Primary outcomes were 30-day conversion rate and postoperative complications. Secondary outcomes included operative time, length of stay, lymph node yield, and 30-day readmission. Multivariable logistic regression was used to adjust for potential confounders.
Results: Robotic colectomy was associated with significantly lower conversion rates compared to laparoscopic (2.2% vs 8.9%, p=0.003). Median hospital stay was shorter in the robotic group (3.1 vs 4.2 days, p<0.001). Overall complication rates were similar (18.3% vs 21.1%, p=0.48). Lymph node yield was equivalent (22.3 vs 21.8 nodes, p=0.61). Operative time was longer for robotic procedures (192 vs 158 minutes, p<0.001).
Conclusions: Robotic colectomy offers significantly lower conversion rates and shorter hospitalization compared to laparoscopic colectomy, with comparable oncologic adequacy. These benefits must be weighed against longer operative times.
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