Comparison of 30-Day Postoperative Outcomes after Laparoscopic vs Robotic Colectomy.
The robotic platform has been used increasingly to perform colorectal surgery. The benefits of robotic colectomy when compared with laparoscopic colectomy have not been definitively established.



A retrospective review of the NSQIP database was performed on patients undergoing elective laparoscopic or robotic colectomy in 2013. Demographic characteristics, length of stay, operative time, and 30-day postoperative complications were compared between the 2 groups.



Of the 17,774 colectomies performed during the study period, 11,267 (63.4%) were performed laparoscopically and 653 (3.7%) were performed robotically. In comparison with laparoscopic colectomy, robotic colectomy was associated with increased operative time (233 vs 180 minutes; p < 0.01) and decreased length of stay (5.04 vs 6.06 days; p < 0.01). There was no significant difference with respect to mortality (0.2% vs 0.4%; p < 0.312), anastomotic leak (3.4% vs 3.1%; p = 0.715), reoperation (4.9% vs 4.0%; p = 0.27), conversion (10.3% vs 12.2%; p = 0.13), or readmission (9.3% vs 8.7%; p = 0.593) rates. The differences in length of stay and operative time persisted in the right colectomy and left colectomy/sigmoid resection subgroup analysis with no difference in conversion rates.



In this head-to-head comparison of laparoscopic colectomy and robotic colectomy, the majority of postoperative outcomes were equivalent, except for an increase in operative time and shorter length of stay in the robotic group. Robotic colectomy appears to be a safe option for minimally invasive colectomy, but additional studies are needed to elucidate whether it is cost-effective when compared with laparoscopic colectomy.
Department of Surgery, Alpert Medical School, Brown University, Rhode Island Hospital, Providence, RI. Electronic address: Peter.Miller@lifespan.org.
Peter E
PE
Miller
Department of Surgery, Saint Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA.
Haisar
H
Dao
Department of Surgery, Saint Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA.
Nivedh
N
Paluvoi
The Lexington Clinic, Lexington, KY.
Matthew
M
Bailey
Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA.
David
D
Margolin
Department of Surgery, Alpert Medical School, Brown University, Rhode Island Hospital, Providence, RI.
Nishit
N
Shah
Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA.
H D
HD
Vargas
D000328:Adult; D000368:Aged; D003082:Colectomy / Q000379:methods*; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures