A propensity score matching study of totally robotic Right Hemicolectomy versus robot-assisted Right Hemicolectomy

Abstract

Abstract Objective To compare and analyze the differences in safety, feasibility and short-term efficacy between robot-assisted and totally robotic surgery in Right Hemicolectomy. Methods A retrospective analysis was conducted on the clinical data of 184 patients who underwent right hemicolectomy in The Second Xiangya Hospital of Central South University from July 2016 to December 2021. 148 patients were matched (including 74 cases of robot-assisted right hemicolectomy (TRAH) and 74 cases of totally robotic right hemicolectomy (TRRH)). The general information, surgical and pathological results and complications of patients were collected and analyzed. Results The incision length was 5.14 ± 0.60cm in the robot-assisted group 4.74 ± 0.55cm in the totally robotic group (p < 0.001). The blood loss was 86.28 ± 52.57 ml in the robot-assisted group and 69.19 ± 44.78 ml in the totally robotic group (p = 0.035).The operative time of the robot-assisted group was 197.50 (171.25, 242.25) min, and that of the totally robotic group was 160.00 (145.00, 188.75) min (p < 0.001).The postoperative hospital stay was 11.18 ± 4.32 days in the robot-assisted group and 9.53 ± 4.42 days in the totally robotic group (p = 0.023). NRS pain scores were 3.05 ± 0.23 for the robot-assisted group and 2.96 ± 0.26 for the totally robotic group (p = 0.019). The extraction time of abdominal drainage was 7.54 ± 1.44 days in the robot-assisted group and 7.00 ± 1.25 days in the totally robotic group (p = 0.016). postoperative complications in the robot-assisted group were as follows: Urinary retention 1 (1.4%), chylous fistula 1 (1.4%), wound complications 3 (4.1%), postoperative intestinal obstruction 1 (1.4%), postoperative anastomosis 3 (4.1%), other complications 4 (5.4%);postoperative complications in the totally robotic group included 0 cases of urinary retention, 7 cases of chylous fistula (9.3%), 1 case of wound complication (1.3%), 0 cases of postoperative intestinal obstruction, 2 cases of postoperative anastomotic complications (2.7%), and 0 cases of other complications. Conclusions Complete robotic right hemicolectomy in the hands of an experienced colorectal surgeon is safe and feasible. Compared with robot-assisted right hemicolectomy, the totally robotic right hemicolectomy group has certain advantages in incision length, operative time, intraoperative blood loss, postoperative hospital stay, first exhaust time, first liquid diet time, Time of drainage tube removal, NRS pain score and postoperative complications.