Robotic right colon resection: evaluation of first 50 consecutive cases for malignant disease.
BACKGROUND
Colorectal cancer is the fourth leading cause of death in the world. Minimally invasive surgery has been demonstrated to have the same oncological results as open surgery, with better clinical outcomes. Robotic assistance is an evolution of minimally invasive technique. This study aims to evaluate surgical and oncological short-term outcomes of robotic-assisted right colon resection in malignant disease.


METHODS
Fifty consecutive patients affected by right-sided colon cancer were operated from May 2001 to May 2009 using the da Vinci(®) surgical system. Data regarding surgical and early oncological outcomes were systematically collected in a specific database for statistical analysis.


RESULTS
Twenty-four male and 26 female patients underwent robotic right colectomy. Median age was 73.34 ± 11 years. Median operative time was 223.50 (180-270) min. No conversion occurred. Specimen length was 26.7 ± 8 cm (range 21-50 cm), number of harvested lymph nodes was 18.76 ± 7.2 (range 12-44), and mean number of positive lymph nodes was 1.65 ± 3 (range 0-17). Surgery-related morbidity was 1/50 (2%): one twisting of the mesentery in one case with extracorporeal anastomosis. All patients were included in a follow-up regimen. Disease-free survival was 90% (45/50), and overall survival was 92% (46/50). Cancer-related mortality was 8% (4/50).


CONCLUSIONS
Robotic assistance allows performance of oncologically adequate dissection of the right colon with radical lymphadenectomy and to fashion a handsewn intracorporeal anastomosis as in open surgery, confirming the safety and oncological adequacy of this technique, with acceptable results and short-term outcomes.
D'Annibale
Annibale
A
Minimally Invasive and Robotic Surgery Unit, San Giovanni-Addolorata Hospital, Rome, Italy.
Pernazza
Graziano
G
Morpurgo
Emilio
E
Monsellato
Igor
I
Pende
Vito
V
Lucandri
Giorgio
G
Termini
Barbara
B
Orsini
Camillo
C
Sovernigo
Gianna
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002430:Cecal Neoplasms / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D044682:Colon, Ascending / Q000601:surgery*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D012371:Robotics; D016896:Treatment Outcome