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Robotic complete mesocolic excision versus conventional robotic right colectomy for right-sided colon cancer: a comparative study of perioperative outcomes

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Abstract

Aim

This study aims to compare the short-term outcomes of robotic complete mesocolic excision (RCME) versus conventional robotic right colectomy (RRC) for right-sided colon cancer.

Methods

Consecutive patients who underwent robotic surgery for right-sided colon cancer in a public quaternary and a private tertiary healthcare centre between November 2018 and June 2020 were included. Clinical, perioperative and histopathological variables were collected and analysed.

Results

Fifty-one patients were included; 25 (49%) of them had an RCME. The groups were evenly distributed in terms of demographic characteristics and tumour location. Operative time was similar between both groups, and no patients required conversion to open surgery. There were no differences in overall complications (16% in RCME vs. 26.9% in RRC; p = 0.499) or their profile between groups. There were no anastomotic leaks recorded, and the reoperation rates were similar (0% for RCME versus 3.8% for RRC; p = 1). In addition, the median length of hospital stay was similar in between the RCME and the RRC groups (4 [4–6] days versus 5 [3–8.5] days, respectively; p = 0.891). Whilst there were no differences in the TNM staging, the mean number of lymph nodes harvested with RCME was 37.7 (±12.9) compared to 21.8 (±7.5) with RCC (p < 0.001).

Conclusion

In our series, RCME was associated with a higher lymph node harvest and a similar morbidity profile compared to RCC. Further studies are required to validate these results and provide long-term oncologic outcomes.

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Author notes

  1. José Tomás Larach and Julie Flynn have contributed equally.

Authors and Affiliations

  1. Division of Cancer Surgery, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, 305 Grattan Street, Melbourne, VIC, 3000, Australia

    José Tomás Larach, Timothy Wright, Jacob J. McCormick, Joseph Kong, Alexander G. Heriot & Satish K. Warrier

  2. Division of Cancer Research, Peter MacCallum Cancer Centre, Victorian Comprehensive Cancer Centre, Melbourne, Australia

    Jacob J. McCormick, Joseph Kong, Alexander G. Heriot & Satish K. Warrier

  3. University of Melbourne, Melbourne, Australia

    Joseph Kong, Alexander G. Heriot & Satish K. Warrier

  4. General Surgery and Gastrointestinal Clinical Institute, Epworth Healthcare, Melbourne, Australia

    Julie Flynn, Amrish K. S. Rajkomar, Jacob J. McCormick, Philip J. Smart, Alexander G. Heriot & Satish K. Warrier

  5. Department of Surgery, Austin Health, Melbourne, Australia

    Philip J. Smart

  6. Department of Digestive Surgery, Pontificia Universidad Católica de Chile, Santiago, Chile

    José Tomás Larach

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  1. José Tomás Larach
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Contributions

All author contributed to (I) conception and design (II) administrative support (III) provision of study materials or patients (IV) collection and assembly of data (V) data analysis and interpretation (VI) manuscript writing, and (VII) final approval of the manuscript

Corresponding author

Correspondence to José Tomás Larach.

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Disclosures

Jose T. Larach is a Robotic Colorectal Fellow financially supported by Device Technologies, Australia. Julie Flynn, Timothy Wright, Amrish K. S. Rajkomar, Jacob J. McCormick, Joseph Kong, Philip J. Smart, Alexander G. Heriot and Satish K. Warrier have no conflicts of interest or financial ties to disclose

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Larach, J.T., Flynn, J., Wright, T. et al. Robotic complete mesocolic excision versus conventional robotic right colectomy for right-sided colon cancer: a comparative study of perioperative outcomes. Surg Endosc 36, 2113–2120 (2022). https://doi.org/10.1007/s00464-021-08498-8

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