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. 2022 Mar;36(3):2113-2120.
doi: 10.1007/s00464-021-08498-8. Epub 2021 Apr 12.

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

José Tomás Larach #  1   2 , Julie Flynn #  3 , Timothy Wright  4 , Amrish K S Rajkomar  3 , Jacob J McCormick  4   5   3 , Joseph Kong  4   5   6 , Philip J Smart  3   7 , Alexander G Heriot  4   5   6   3 , Satish K Warrier  4   5   6   3
Affiliations

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

José Tomás Larach et al. Surg Endosc. 2022 Mar.

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.

Keywords: Colon cancer; Complete mesocolic excision; D3 lymphadenectomy; Right hemicolectomy; Robotic colectomy.

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