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Feasibility of robotic right colectomy with complete mesocolic excision and intracorporeal anastomosis: short-term outcomes of 161 consecutive patients

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Abstract

Technical and oncological aspects are still debated when dealing with minimally-invasive right colectomy. Main controversial issues still remain about whether the anastomosis should be performed intra- or extracorporeally and if a complete mesocolic excision (CME) should be carried out. We report the feasibility of robotic right colectomy with CME and intracorporeal anastomosis (IA) for right sided colon cancer. Data from patients who underwent robotic right colectomy with IA and CME from January 2015 to April 2020 were prospectively collected and retrospectively analyzed. Intraoperative outcomes and complications (minor I–II and major III–IV according to Clavien–Dindo classification), conversion rate, 30-day postoperative outcomes and pathological outcomes were the variables assessed. A total of 161 patients undergoing robotic right colectomy for cancer met the inclusion criteria. Mean operative time was 185 min, no intraoperative complications were observed, and the conversion rate was 3.7% (6 patients requiring elective conversions). Overall, mean postoperative stay was 4.9 days and the overall 30-day complication rate was 16.1%. 20 patients (12.4%) had minor complications, while major postoperative complications occurred in six patients (3.7%). Anastomotic leak was recorded in one patient (0.6%) and the 30-day re-admission rate was 0.6%. Mean number of harvested lymph nodes was 21.9. Patients requiring conversion experienced two minor complications, with a mean length of stay of 7 days. Robotic right colectomy with CME and IA is feasible and it is associated with good intraoperative and short-term postoperative clinical outcomes.

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Authors and Affiliations

  1. Department of Surgery, San Paolo Hospital, University of Milano, Via A. di Rudinì 8, 20142, Milan, Italy

    Paolo Pietro Bianchi & Adelona Salaj

  2. Department of General and Minimally Invasive Surgery, Misericordia Hospital, Grosseto, Italy

    Giuseppe Giuliani & Giampaolo Formisano

  3. Department of Advanced Biomedical Sciences, “Federico II” University, Naples, Italy

    Luca Ferraro

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Correspondence to Paolo Pietro Bianchi.

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Adelona Salaj, MD; Giuseppe Giuliani, MD; Luca Ferraro, MD; and Giampaolo Formisano, MD FACS have no conflicts of interest or financial ties to disclose. Paolo Pietro Bianchi is proctor for Intuitive Surgical Inc.

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Bianchi, P.P., Salaj, A., Giuliani, G. et al. Feasibility of robotic right colectomy with complete mesocolic excision and intracorporeal anastomosis: short-term outcomes of 161 consecutive patients. Updates Surg 73, 1065–1072 (2021). https://doi.org/10.1007/s13304-021-01001-x

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