title: Robotic, laparoscopic, and open colectomy: a case-matched comparison from the ACS-NSQIP.
abstract: BACKGROUND
  This study aimed to compare perioperative outcomes of patients undergoing robotic, laparoscopic, and open colectomy using a procedure-targeted database.
  
  
  METHODS
  Retrospective review of patients undergoing elective colectomy in 2013 was conducted using the procedure-targeted database of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Robotic, laparoscopic, and open groups were matched (1:1:1) based on age, gender, body mass index, surgical procedure, diagnosis and ASA classification. Demographics, comorbidities, and short-term (30 day) outcomes were compared.
  
  
  RESULTS
  Out of 12 790 patients, 387 fulfilled criteria per group after matching. Univariate comparison showed operating time was longer (P < 0.001) and hospital stay was shorter (P < 0.001) in the robotic group. Morbidity (P < 0.001), superficial SSI (P < 0.001), bleeding requiring transfusion (P < 0.001), ventilator dependency (P = 0.003), and ileus (P < 0.001) rates were lower in the robotic group. After adjusting for confounders, outcomes were comparable between the groups except hospital stay which was shorter in the robotic group (P < 0.001).
  
  
  CONCLUSIONS
  ACS-NSQIP data demonstrated several short-term advantages of robotic surgery compared with laparoscopic and open surgery.
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Benlice
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Erman
authors.initials: E
authors.lastname: Aytac
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Meagan
authors.initials: M
authors.lastname: Costedio
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Hermann
authors.initials: H
authors.lastname: Kessler
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Maher A
authors.initials: MA
authors.lastname: Abbas
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Feza H
authors.initials: FH
authors.lastname: Remzi
authors.affiliation: Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, Ohio, USA.
authors.forename: Emre
authors.initials: E
authors.lastname: Gorgun
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000209:etiology; D058996:Quality Improvement; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome
keywords: ACS-NSQIP; colorectal surgery; laparoscopic surgery; open surgery; robotic surgery