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A Comparison of 30-day Postoperative Outcomes Following Laparoscopic Versus Robotic Colectomy
*Peter E Miller1, *Matthew Bailey1, *Nivedh Paluvoi2, *David Margolin1, *David Beck3, *Charles Whitlow3, *David Vargas1, Nishit Shah4
1Ochsner Medical Center, New Orleans, LA;2Steward Saint Elizabeth's Medical Center, Boston, MA;3Saint Elizabeth's Medical Center, Brighton, MA;4Rhode Island Hospital, Providence, RI
Objective:
To compare 30 day postoperative outcomes in patients that underwent elective laparoscopic or robotic colectomy
Design:
Retrospective review of patients using ACS-NSQIP database for the year 2013
Patients:
All patients that underwent laparoscopic or robotic colectomy. Patients that underwent emergent surgery and patients that were diagnosed with pre-operative sepsis were excluded.
Main Outcome Measures:
Length of stay, operative time, postoperative complications (within 30 days).
Results:
Of the 17,774 colectomies included during the study period, 11,237 (63.4%) were LC and 653 (3.7%) were RCs. In comparison with LC, RC was associated with increased operative time (233 vs 180 mins; 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 rate (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 rate (10.3% vs 12.2%, p=0.13), or readmission (9.3% vs 8.7%, p=0.593).
Conclusions:
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 further studies are needed to elucidate whether it is cost-effective when compared to laparoscopic colectomy.
Table 1. Comparison of perioperative outcomes in patients undergoing laparoscopic or robotic colectomy
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