A Retrospective Comparison of 90-day Outcomes, Length of Stay, & Readmissions Between Robotic-Assisted & Laparoscopic Colectomy

Abstract

Abstract Purpose: Investigations generally assess 30-day perioperative outcomes with robotic-assisted and laparoscopic colectomy. Outcomes beyond 30-days serve as a quality metric of surgical services and an assessment of 90-day outcomes may have greater clinical utility. The purpose of this study was to assess 90-day outcomes, length of stay (LOS), and readmissions among patients who underwent a robotic-assisted versus laparoscopic colectomy using a national database. Methods: Patients undergoing either robotic-assisted or laparoscopic colectomy were identified using Current Procedural Terminology (CPT) codes within PearlDiver, a national, inpatient records database from 2010-2019. Outcomes were defined using the National Surgical Quality Improvement Program (NSQIP) risk calculator and identified using International Classification of Disease (ICD) diagnosis codes. Categorical variables were compared using chi-square tests and continuous variables were compared using paired t-tests. Covariate-adjusted regression models were also constructed to evaluate these associations while accounting for potential confounders. Results: A total of 82,495 patients were assessed in this study. At 90-days, patients of the laparoscopic colectomy cohort experienced a higher rate of complications than patients who underwent robotic-assisted colectomy (9.5% vs. 6.6%, p<0.001). There were no significant differences in LOS (6 days vs. 6.5 days, p=0.08) and readmissions (6.1% vs. 6.7%, p=0.851) at 90-days. Conclusion: Patients undergoing robotic-assisted colectomy have a lower risk for morbidity at 90-days. Neither approach is superior for LOS or 90-day readmissions. Both techniques are effective minimally invasive procedures, yet patients may gain a greater risk benefit from robotic colectomy.