Robotic versus laparoscopic right hemicolectomy with complete mesocolic excision using a cranial approach: a propensity score-matched retrospective cohort study.

BACKGROUND

This study aimed to compare the perioperative outcomes of robotic versus laparoscopic complete mesocolic excision (CME) and to assess the safety and feasibility of robotic CME (R-CME) for right-sided colon cancer. As part of this analysis, the feasibility and safety of the robotic approach were also evaluated.

METHODS

Patients who underwent right hemicolectomy with either robotic CME (R-CME, 48 patients) or laparoscopic CME (L-CME, 123 patients) between April 2016 and December 2023 were retrospectively analyzed using propensity score matching (PSM).

RESULTS

After matching, the R-CME and L-CME groups each of the 40 included patients. The R-CME group had less intraoperative blood loss (P = 0.007), a shorter median time to first flatus (P < 0.001), and a shorter median postoperative hospital stay (P = 0.012) than the L-CME group. The other surgical outcomes were not significantly different between the two groups.

CONCLUSIONS

R-CME was associated with less blood loss, faster recovery of bowel function, and shorter hospital stay than L-CME, suggesting that robotic CME using a cranial approach may be a feasible and safe option for right-sided colon cancer. These favorable outcomes may reflect not only the general advantages of the robotic platform but also the procedural benefits of the cranial approach, which enables early vascular control and reduced bowel interference.