Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis
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2024
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| author | Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan |
| author_facet | Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan |
| collection | Wiley Open Access |
| contents | Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan Colorectal Disease AbstractAimMinimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking.MethodsThis was a multicentre propensity score‐matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra‐ and postoperative complication rates, overall (OS), and disease‐free survival (DFS).ResultsAmong a total of 200 patients, 39 RRC were compared with 78 PS‐matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1‐, 3‐ and 5‐year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC.ConclusionAdequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short‐term postoperative outcomes. 10.1111/codi.17089 http://creativecommons.org/licenses/by/4.0/ |
| doi_str_mv | 10.1111/codi.17089 |
| format | Artículo Open Access |
| id | wiley_oa_10_1111_codi_17089 |
| institution | Wiley Open Access |
| license_str_mv | http://creativecommons.org/licenses/by/4.0/ |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan Colorectal Disease Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis Nicola de'Angelis Carlo Alberto Schena Eloy Espin‐Basany Micaela Piccoli Sergio Alfieri Filippo Aisoni Federico Coccolini Alice Frontali Miquel Kraft Zaher Lakkis Bertrand Le Roy Andrea Pierre Luzzi Marco Milone Gianmaria Casoni Pattacini Gianluca Pellino Roberto Petri Guglielmo Niccolò Piozzi Giuseppe Quero Frederic Ris Des C. Winter Jim Khan Colorectal Disease AbstractAimMinimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking.MethodsThis was a multicentre propensity score‐matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra‐ and postoperative complication rates, overall (OS), and disease‐free survival (DFS).ResultsAmong a total of 200 patients, 39 RRC were compared with 78 PS‐matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1‐, 3‐ and 5‐year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC.ConclusionAdequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short‐term postoperative outcomes. 10.1111/codi.17089 http://creativecommons.org/licenses/by/4.0/ |
| title | Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score‐matched analysis |
| topic | Colorectal Disease |
| url | https://onlinelibrary.wiley.com/doi/10.1111/codi.17089 |