Comparison of the short-term and mid-term outcomes between robot-assisted and laparoscopic surgery for splenic flexure colon cancer.

PURPOSE: This study compared short- and mid-term outcomes between robot-assisted surgery (Robot) and laparoscopic surgery (Lap) for splenic flexure colon cancer. METHODS: We analyzed patients who underwent minimally invasive surgery for splenic flexure colon cancer between April 2018 and November 2024. The patients were divided into the Robot and Lap groups. The perioperative outcomes, postoperative complications, and survival data were also evaluated. The overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan–Meier method. RESULTS: In total, 32 and 20 patients underwent Robot and Lap, respectively. The Robot group had a significantly higher rate of lymph node dissection with division of the left branch of the middle colic artery (43.8% vs. 15.0%, p = 0.038), less intraoperative blood loss (0 mL vs. 28 mL, p = 0.008), and more frequent intracorporeal anastomosis (34.4% vs. 0.0%, p = 0.004). The postoperative complications and pathological outcomes were similar. The 3-year DFS rates were comparable (Robot: 80.7% vs. Lap: 91.7%, p = 0.629). CONCLUSION: Robot-assisted surgery for splenic flexure colon cancer resulted in reduced blood loss and similar short- and mid-term outcomes compared with laparoscopic surgery. Robotic systems may offer enhanced precision for complex procedures and thereby improve the safety and technical performance.