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Single-incision robotic colectomy versus single-incision laparoscopic colectomy: A matched case control study
Authors:Tung-Cheng Chang  En-Kwang Lin  Yen-Jung Lu  Ming-Te Huang  Chien-Hsin Chen
Institution:1. Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291 Zhongzheng Road, Zhonghe District, Taipei, Taiwan;2. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;3. Division of Colorectal Surgery, Department of Surgery, WanFang Hospital, Taipei Medical University, No.111 Sec. 3 Xinglong Rd., Wenshan Dist., Taipei, Taiwan;4. Division of General Surgery, Department of Surgery, Taipei Medical University Shuang-Ho Hospital, Number 291 Zhongzheng Road, Zhonghe District, Taipei, Taiwan
Abstract:BackgroundSingle incision laparoscopic colectomy (SILC) and single incision robotic colectomy (SIRC) are both advanced minimally invasive operative techniques. However, studies comparing these two surgical methods have not been published. The purpose of this study is to compare and evaluate the short-term outcomes of SIRC with those of SILC.MethodsA total of 21 consecutive patients underwent SIRC and 136 consecutive patients underwent SILC in separate institutes between January 2013 and December 2019. We used retrospective cohort matching to analyze these patients.ResultsPrior to matching, patients who underwent SIRC had a lower percentage of American Society of Anesthesiologists (ASA) grades III–IV (5% vs. 19%, P = 0.11) compared with patients who underwent SILC. The SIRC group revealed a higher proportion of sigmoid colon lesions and anterior resections than the SILC group (61% vs. 45%, P = 0.16). After 1:4 cohort matching, 21 patients were enrolled in the SIRC group and 84 patients were enrolled in the SILC group. No statistically significant difference in terms of operative time (SIRC: 185 ± 46 min, SILC: 208 ± 53 min; P = 0.51), estimated blood loss (SIRC: 12 ± 22 ml, SILC: 85 ± 234 ml; P = 0.12), and complications (SIRC: 4.7%, SIRC: 7.1%; P = 0.31) was observed between these groups. Length of postoperative hospital stay (SIRC: 8.3 ± 1.7 days, SILC: 9.3 ± 6.5; P = 0.10) and number of harvested lymph nodes (SIRC: 21.3 ± 10.3, SILC: 21.3 ± 9.5; P = 0.77) were also similar between the two groups. In subgroup analysis, numbers of harvested lymph node is less in SIRC than SILC (SIRC: 18.1 ± 4.7 vs. SILC: 18.9 ± 8.1, P = 0.04) in anterior resection.ConclusionSIRC and SILC are safe and feasible procedures with similar surgical and pathological outcomes for right- and left-side colectomy.
Keywords:Single-incision  Robotic colectomy  Laparoscopic colectomy  Minimal invasive surgery  Colon cancer
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