EP284 - Short- and Long-Term Outcomes of Robotic vs. Laparoscopic Right Hemicolectomy: A Multicenter Retrospective Study

Purpose/Background: Colorectal cancer has become the second most incident cancer and the fourth leading cause of cancer-related death in China, with the disease burden increasing annually. This multicenter study compares robotic versus laparoscopic right hemicolectomy for colon cancer. While laparoscopy is well-established, robotic surgery offers potential technical advantages like 3D visualization and enhanced precision, though it faces debate over cost and efficacy. The study aims to evaluate the feasibility, safety, and oncologic outcomes of both approaches.

Methods/Interventions: This Multicenter Retrospective comparative study included patients who underwent robotic or laparoscopic right hemicolectomy from different 3 Chinese surgical departments between July 2016 and June 2024. The inclusion criteria for this study required colon cancer lesions to be located at the hepatic flexure, ascending colon, or cecum, as confirmed by colonoscopy; the pathological biopsy revealed adenocarcinoma, and the clinical staging was diagnosed as clinical stages I to IV according to the American Joint Committee on Cancer (AJCC) TNM classification (8th edition); the patients plan to undergo right hemicolectomy and D2 or D3 lymph node dissection; the enrolled patients included those with stage IV disease who underwent right hemicolectomy due to local symptoms (obstruction or bleeding) or other reasons; the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) is 0 or 1. All patient data were retrospectively collected and reviewed to compare the differences in perioperative conditions, pathology, and oncological prognosis between the two groups.

Results/Outcomes: A total of 771 patients with right hemicolectomy were included, with 385 patients undergoing RRC (robotic right hemicolectomy) , while 386 patients underwent laparoscopic surgery. There were no statistical differences regarding the sex, age, body mass index (BMI), tumor location, total surgical time, postoperative complications and American Joint Committee on Cancer (AJCC) staging system between these two groups (p > 0.05).The total number of lymph nodes retrieved and the number of positive lymph nodes were higher in the robotic group than in the laparoscopic group, though this difference was not statistically significant (p > 0.05). The robotic group performed more intracorporeal anastomoses (p = 0.012), while the laparoscopic group performed more side-to-side anastomoses (p = 0.002), with both differences being statistically significant.The robotic group had a significantly shorter length of hospital stay compared to the laparoscopic group (p = 0.033). In contrast, the total hospitalization costs for the robotic group were significantly higher than those for the laparoscopic group (p < 0.001).The median follow-up period for the patient was 60 months. The DFS of robotic and laparoscopic groups was 80.5% and 82.2%, respectively, and the OS was 84.8% and 83.7%, respectively, with no statistical difference.

Conclusion/Discussion: Our study indicates that robotic right hemicolectomy is a safe and effective procedure. Further well-designed, prospective, multicenter randomized controlled trials are needed. In the coming years, it is expected that the challenges associated with the Da Vinci surgical system, especially its increased cost, will be addressed, allowing this promising technology to be more widely adopted.

Table 1. Intraoperative, postoperative outcomes and pathological information
Figure 1. Kaplan-Meier survival curve shows disease-free survival (A) and overall survival (B) of patients with AJCC stage III , and disease-free survival (C) and overall survival (D ) of patients with AJCC stage I-III .