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CC BY 4.0 · Journal of Coloproctology 2024; 44(S 01): S1-S138
DOI: 10.1055/s-0045-1808812
Temas Gerais Dentro da Especialidade
General Topics Within the Specialty
ID – 138278
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COMPARATIVE MATCHED STUDY BETWEEN EARLY POSTOPERATIVE OUTCOMES OF LAPAROSCOPIC SURGERY AND LAPAROSCOPIC SURGERY WITH ROBOTIC PLATFORM

Authors

  • Bárbara Maria Tavares Pereira

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Fábio Lopes de Queiroz

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Marina Barbabela Grisolia de Oliveira

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Lucas Alves Bessa Cardoso

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Daniel Maurício Londoño Estrada

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Letícia Brandão Castro

    1   Hospital Felício Rocho, Belo Horizonte, Brasil

  • Artur Duarte e Duarte

    1   Hospital Felício Rocho, Belo Horizonte, Brasil
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Introduction Minimally invasive surgery (MIS) has improved postoperative outcomes, reduced the inflammatory response to trauma, and accelerated recovery after surgical procedures. Despite the advantages provided by laparoscopic surgery (LS), of the 320,000 colectomies performed in the USA in 2012, only 59% were performed laparoscopically. The limited range of motion of instruments in the two-dimensional view of the pelvic cavity and the unstable camera view are some of the technical limitations. The development of robotic platforms emerged as a tool to minimize the technical difficulties of laparoscopic surgery. Despite the promise of minimizing the disadvantages of laparoscopy, robotic-assisted surgery (RAS) is still not standardized. Studies evaluating both LS and RAS are scarce, and there is a lack of research comparing safety and surgical outcomes between MIS modalities.

Objective To evaluate 30-day complications and length of hospitalization in RAS compared to LS in patients undergoing colorectal surgery.

Method A retrospective, single-center, comparative cohort study conducted from November 2017 to December 2022. Patients were allocated into two groups based on the surgical approach used: LS vs RAS. Propensity score matching (PSM) was performed considering variables such as age, gender, and ASA score.

Results After PSM, 65 patients who underwent RAS and 85 patients who underwent LS were included in the study. The proportion of total mesorectal excision with rectosigmoidectomy was higher in the RAS group and lower in the LS group (19.4% vs. 5.9%, p=0.003), and the same occurred for shaving in intestinal endometriosis (6% vs. 0%, p=0.003). Complications were more prevalent in the LS group (p=0.015). When comparing type I complications, the incidence was 74.7% (n=47) in LS and 62.2% (n=23) in RAS (p<0.001). The proportion of type 3B complications, which involve the need for surgical re-intervention under general anesthesia, was higher in the LS group with 4.8% (n=3). The RAS group did not have any type 3B complications (p=0.014).

Conclusion This study demonstrated that the robotic platform is safe, with a lower complication rate and no increase in length of hospitalization.


No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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