Robotic versus laparoscopic right colectomy for nonmetastatic pT4 colon cancer: A European multicentre propensity score-matched analysis.
T4 cancer
locally advanced colon cancer
minimally invasive surgery
propensity score matching
right colon cancer
robotic surgery
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
08 Jul 2024
08 Jul 2024
Historique:
revised:
14
04
2024
received:
29
11
2023
accepted:
16
04
2024
medline:
9
7
2024
pubmed:
9
7
2024
entrez:
8
7
2024
Statut:
aheadofprint
Résumé
Minimally 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. This 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). Among 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. Adequate 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.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Francesca Pecchini
(F)
Lauren O'Connell
(L)
Paolo Carcoforo
(P)
Jean-Christophe Paquet
(JC)
Alessia Urbani
(A)
Dario Tartaglia
(D)
Massimo Chiarugi
(M)
Francesco Arces
(F)
Christine Denet
(C)
Monica Ortenzi
(M)
Laura Vidal
(L)
Céphise Antonot
(C)
Jeanne Vertier
(J)
Ornella Perrotto
(O)
Giovanni Domenico De Palma
(GD)
Antonio Santangelo
(A)
Raffaele De Rosa
(R)
Emanuele Romairone
(E)
Ugo Giuseppe Ribeca
(UG)
Angelo Restivo
(A)
Simona Deidda
(S)
Lorenzo Orci
(L)
Sebastiano Bartoletti
(S)
Enrico Andolfi
(E)
Salomone Di Saverio
(S)
Giorgio Bianchi
(G)
Pietro Genova
(P)
Mario Guerrieri
(M)
Renato Micelli Lupinacci
(R)
Stefano Scabini
(S)
Valeria Tonini
(V)
Alain Valverde
(A)
Luigi Zorcolo
(L)
David Fuks
(D)
Valerio Celentano
(V)
Claudio Fiorillo
(C)
Davide De Sio
(D)
Aleix Martínez-Pérez
(A)
Francesco Marchegiani
(F)
Informations de copyright
© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
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