EAES Academy

Introduction:

Colorectal cancer is considered one of the most common cancer types worldwide, accounting for approximately 10% of all annually diagnosed cancers and cancer-related deaths. Right-sided colon cancer constitutes approximately 40% of all colorectal cancer.
Aims: The aims of the literature review were to evaluate the intraoperative, postoperative, survival, and histopathological outcomes, together with cost-effectiveness, comparing laparoscopic right hemicolectomies (LRC) and robotic right hemicolectomies (RRC) for right colon cancer.
Objectives: The specific outcomes assessed included intraoperative blood loss, operative duration, conversion to open procedure (CTOP), overall complications, anastomotic leak frequency, surgical wound infections, time to first flatus, time to first oral diet, length of stay (LOS), mortality rates, resected lymph node yield (LNY), resection margins and cost.
Methodology: A literature review was performed to execute the aims above. Each critiqued article was assigned a level of evidence according to the level of evidence by Harbour and Mills (2001) and each outcome was compared to that in other studies so as to establish an overall conclusion. A list of recommendations was produced summarizing comparability or significant difference between
robotic and laparoscopic surgery for right hemicolectomy in right colon cancer. A grade of evidence was assigned to the recommendations formulated.
Results:

The results of this literature review concluded comparability between LRC and RRC in terms of intraoperative complications, overall postoperative complications, anastomotic leak rates, postoperative haemorrhage occurrence, abdominal abscess formation rates, postoperative ileus occurrence, non-surgical complications prevalence, wound infection rates, incisional hernia development, pain occurrence, unplanned readmission rates, and re-operation rates. In terms of postoperative bowel recovery, LOS, mortality, survival, and histopathological variables, including LNY, findings were also comparable between the two modalities. A RRC was deemed advantageous in terms of intraoperative blood loss and CTOP, however, limitations persist in terms of operative duration and cost.
Conclusion:
The main findings were an increased operative duration and costs when undergoing a RRC, with an advantage regarding intraoperative blood loss and CTOP. Other intraoperative, postoperative, survival, and histopathological variables were comparable.