Comparison of Robot-Assisted and Laparoscopic Right Hemicolectomy for Right-Sided Colon Cancer: A Report on the Short-Term Perioperative Outcomes Using Propensity Score Matching

Abstract

Background: Robot-assisted right hemicolectomy has gained popularity as a minimally invasive procedure that may provide precise lymph node dissection and reduced surgical stress. However, data comparing its advantages to conventional laparoscopic right hemicolectomy remain limited. This study aimed to clarify the safety and efficacy of robot-assisted right hemicolectomy for colon cancer.

Methods: We retrospectively analyzed patients who underwent right hemicolectomy between January 2019 and December 2024. Patients who had open resections from the outset, emergency surgeries, or D1 or lower lymph node dissection were excluded. Propensity score matching balanced baseline characteristics such as age, sex, body mass index, ASA-PS, tumor location, and clinical stage. We compared perioperative outcomes between robot-assisted and laparoscopic groups.

Results: A total of 158 patients met the criteria, and matched cohorts were created with comparable characteristics. There was no significant difference in Clavien-Dindo Grade II or higher complications or hospital stay length between groups. However, the robot-assisted group had lower intraoperative blood loss, higher intracorporeal anastomosis rates, and more extensive lymph node retrieval. Operative times were similar, and no conversions to open surgery occurred in the robot-assisted group.

Conclusions: Robot-assisted right hemicolectomy can be performed safely without increasing postoperative complications or prolonging operative time. Its potential advantages-reduced blood loss and improved lymph node dissection-warrant further investigation in larger multicenter trials.

Keywords: colorectal cancer; laparoscopic surgery; propensity score matching; right hemicolectomy; robot‐assisted surgery.