Annals of the Royal College of Surgeons of England · 2025
Comparison of laparoscopic and robotic right hemicolectomy: insights from a single centre.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Yusufi M A, Mateen U, Uneeb M, Gupta M, Muhibullah N, Siddiqi N N
Аннотация
INTRODUCTION: Right hemicolectomy has evolved from open to minimally invasive approaches. Laparoscopic right hemicolectomy (LRH) is widely adopted, yet challenges persist, particularly in complex dissections. Robotic right hemicolectomy (RRH) offers enhanced precision and ergonomics but remains under scrutiny for its comparative advantages. This study critically evaluates the perioperative outcomes of LRH vs RRH within a single-centre framework.
METHODS: A retrospective cohort analysis was carried out at a single tertiary institution, reviewing all RRH cases from January 2021 to December 2024 and comparing them with the most recent LRH cases. Inclusion criteria encompassed adults undergoing elective right hemicolectomy for confirmed malignancy; patients with recurrent disease or emergency indications were excluded. Demographics, tumour characteristics, operative details and short-term outcomes were compared using appropriate statistical tests.
RESULTS: The baseline demographics were comparable between the groups. Transverse colon tumours were more frequent in the RRH group (n = 15, 37.5%) than in the LRH group (n = 2, 5%) (p = 0.003). The mean operative time was comparable in both groups (219.9mi in RRH vs 206.8min in LRH; p = 0.277). RRH demonstrated significantly reduced blood loss (24 vs 50.1 m; p < 0.001), earlier return of bowel function (1.9 vs 2.6 days; p = 0.004), and a reduced hospital stay (3.5 vs 6.1 days; p = 0.001). Lymph node yield was comparable.
CONCLUSION: RRH offers measurable benefits in recovery and haemostasis as compared with LRH. It offers equivalent short-term oncological outcomes without prolonging the operative time. Our findings suggest RRH may be preferable for anatomically complex cases. Larger, prospective studies with a long-term follow-up period are therefore indicated.
METHODS: A retrospective cohort analysis was carried out at a single tertiary institution, reviewing all RRH cases from January 2021 to December 2024 and comparing them with the most recent LRH cases. Inclusion criteria encompassed adults undergoing elective right hemicolectomy for confirmed malignancy; patients with recurrent disease or emergency indications were excluded. Demographics, tumour characteristics, operative details and short-term outcomes were compared using appropriate statistical tests.
RESULTS: The baseline demographics were comparable between the groups. Transverse colon tumours were more frequent in the RRH group (n = 15, 37.5%) than in the LRH group (n = 2, 5%) (p = 0.003). The mean operative time was comparable in both groups (219.9mi in RRH vs 206.8min in LRH; p = 0.277). RRH demonstrated significantly reduced blood loss (24 vs 50.1 m; p < 0.001), earlier return of bowel function (1.9 vs 2.6 days; p = 0.004), and a reduced hospital stay (3.5 vs 6.1 days; p = 0.001). Lymph node yield was comparable.
CONCLUSION: RRH offers measurable benefits in recovery and haemostasis as compared with LRH. It offers equivalent short-term oncological outcomes without prolonging the operative time. Our findings suggest RRH may be preferable for anatomically complex cases. Larger, prospective studies with a long-term follow-up period are therefore indicated.