Robotic versus laparoscopic right colectomy for cancer: short-term outcomes and influence of Body Mass Index on conversion rate.

ABSTRACT

BACKGROUND: It is still controversial if the robotic colorectal surgery provides any advantage compared to conventional laparoscopy. We compared the short-term outcomes of robotic right colectomy (RRC) and laparoscopic right colectomy (LRC) and the influence of Body Mass Index (BMI) on each one. METHODS: Between September 2013 and April 2015, 60 LRC and 30 RRC were performed for colorectal cancer in our institution. Comparison was based on quality of surgical procedure, postoperative and oncological outcomes. The BMI was evaluated as a conversion risk factor. RESULTS: A higher surgery time (P<0.001), a higher operative room setting (P<0.001), a lower time of first flatus (P<0.035) and oral feeding recovery (P<0.034) resulted in RRC group. The probability of conversion to open colectomy was higher for LRC group, but not significantly (P=0.659). The conversion rate was higher in obese patients for both procedures (P<0.001). No difference between the two techniques was reported in the obese class with regard to the conversion rate (P=0.282). Both procedures proved acceptable oncological safety. CONCLUSIONS: RRC offers slightly advantages to the LRC with extracorporeal anastomosis, even if it still requests increased time and costs. This study suggested that this difference increases when BMI rises.