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Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study
BACKGROUND: Robotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, sho...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598969/ https://www.ncbi.nlm.nih.gov/pubmed/26452727 http://dx.doi.org/10.1186/s12957-015-0708-1 |
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author | de’Angelis, Nicola Alghamdi, Salah Renda, Andrea Azoulay, Daniel Brunetti, Francesco |
author_facet | de’Angelis, Nicola Alghamdi, Salah Renda, Andrea Azoulay, Daniel Brunetti, Francesco |
author_sort | de’Angelis, Nicola |
collection | PubMed |
description | BACKGROUND: Robotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon’s psychological stress and physical pain. METHODS: The study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon’s stress and pain were assessed before and after surgery on a 0–100-mm visual analog scale. RESULTS: The demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon’s stress was not different between RC and LC, whereas the surgeon’s hand and neck/shoulder pain were significantly lower after RC. CONCLUSIONS: RC for transverse colon cancer appears to be safe and feasible with short-term outcomes comparable to LC. |
format | Online Article Text |
id | pubmed-4598969 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-45989692015-10-09 Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study de’Angelis, Nicola Alghamdi, Salah Renda, Andrea Azoulay, Daniel Brunetti, Francesco World J Surg Oncol Technical Innovations BACKGROUND: Robotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon’s psychological stress and physical pain. METHODS: The study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon’s stress and pain were assessed before and after surgery on a 0–100-mm visual analog scale. RESULTS: The demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon’s stress was not different between RC and LC, whereas the surgeon’s hand and neck/shoulder pain were significantly lower after RC. CONCLUSIONS: RC for transverse colon cancer appears to be safe and feasible with short-term outcomes comparable to LC. BioMed Central 2015-10-09 /pmc/articles/PMC4598969/ /pubmed/26452727 http://dx.doi.org/10.1186/s12957-015-0708-1 Text en © de’Angelis et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Technical Innovations de’Angelis, Nicola Alghamdi, Salah Renda, Andrea Azoulay, Daniel Brunetti, Francesco Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title | Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title_full | Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title_fullStr | Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title_full_unstemmed | Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title_short | Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
title_sort | initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study |
topic | Technical Innovations |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4598969/ https://www.ncbi.nlm.nih.gov/pubmed/26452727 http://dx.doi.org/10.1186/s12957-015-0708-1 |
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