title: Comparison of robotic and laparoscopic colorectal resections with respect to 30-day perioperative morbidity.
abstract: BACKGROUND
  Robotic surgery has emerged as a minimally invasive alternative to traditional laparoscopy. Robotic surgery addresses many of the technical and ergonomic limitations of laparoscopic surgery, but the literature regarding clinical outcomes in colorectal surgery is limited. We sought to compare robotic and laparoscopic colorectal resections with respect to 30-day perioperative outcomes.
  
  
  METHODS
  The American College of Surgeons National Surgical Quality Improvement Program database was used to identify all patients who underwent robotic or laparoscopic colorectal surgery in 2013. We performed a logistic regression analysis to compare intraoperative variables and 30-day outcomes.
  
  
  RESULTS
  There were 8392 patients who underwent laparoscopic colorectal surgery and 472 patients who underwent robotic colorectal surgery. The robotic cohort had a lower incidence of unplanned intraoperative conversion (9.5% v. 13.7%, p = 0.008). There were no significant differences between robotic and laparoscopic surgery with respect to other intraoperative and postoperative outcomes, such as operative duration, length of stay, postoperative ileus, anastomotic leak, venous thromboembolism, wound infection, cardiac complications and pulmonary complications. On multivariable analysis, robotic surgery was protective for unplanned conversion, while male sex, malignancy, Crohn disease and diverticular disease were all associated with open conversion.
  
  
  CONCLUSIONS
  Robotic colorectal surgery has comparable 30-day perioperative morbidity to laparoscopic surgery and may decrease the rate of intraoperative conversion in select patients.
authors.affiliation: From the Department of Surgery, University of Toronto, Toronto, Ont. (Feinberg, Quereshy); the Division of General Surgery, University Health Network, Toronto, Ont. (Elnahas, Cleghorn, Quereshy); the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Bashir); and the Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont. (Quereshy).
authors.forename: Adina E
authors.initials: AE
authors.lastname: Feinberg
authors.affiliation: From the Department of Surgery, University of Toronto, Toronto, Ont. (Feinberg, Quereshy); the Division of General Surgery, University Health Network, Toronto, Ont. (Elnahas, Cleghorn, Quereshy); the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Bashir); and the Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont. (Quereshy).
authors.forename: Ahmad
authors.initials: A
authors.lastname: Elnahas
authors.affiliation: From the Department of Surgery, University of Toronto, Toronto, Ont. (Feinberg, Quereshy); the Division of General Surgery, University Health Network, Toronto, Ont. (Elnahas, Cleghorn, Quereshy); the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Bashir); and the Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont. (Quereshy).
authors.forename: Shaheena
authors.initials: S
authors.lastname: Bashir
authors.affiliation: From the Department of Surgery, University of Toronto, Toronto, Ont. (Feinberg, Quereshy); the Division of General Surgery, University Health Network, Toronto, Ont. (Elnahas, Cleghorn, Quereshy); the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Bashir); and the Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont. (Quereshy).
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Cleghorn
authors.affiliation: From the Department of Surgery, University of Toronto, Toronto, Ont. (Feinberg, Quereshy); the Division of General Surgery, University Health Network, Toronto, Ont. (Elnahas, Cleghorn, Quereshy); the Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Ont. (Bashir); and the Department of Surgical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ont. (Quereshy).
authors.forename: Fayez A
authors.initials: FA
authors.lastname: Quereshy
mesh_terms: D000328:Adult; D000368:Aged; D003106:Colon / Q000601:surgery*; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012007:Rectum / Q000601:surgery*; D012042:Registries; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*