Robotic vs laparoscopic right colectomy – the burden of age and comorbidity in perioperative outcomes: An observational study

Table 1 Pre-operative variables

	RRH (n = 55)	LRH (n = 68)	P value
Age, median (IQR)	72 (65-79)	72 (64-79.5)	0.701
Age, n (%)			0.459
< 75 yr	32 (58.2)	44 (64.7)
≥ 75 yr	23 (41.8)	24 (35.3)
Gender, M, n (%)	32 (58.1)	40 (58.8)	0.943
BMI (kg/m2), median (IQR)	24.31 (22.11-27.56)	24.81 (23.10 -28.45)	0.335
ASA class, n (%)			0.503
1	13 (23.6)	12 (17.7)
2	28 (50.9)	35 (51.5)
3	13 (23.7)	21 (30.8)
4	1 (1.8)	0 (0.0)
ACCI, median (IQR)	6 (4-7)	6 (5-7)	0.556
ACCI, n (%)			0.662
< 7	40 (72.7)	47 (69.1)
≥ 7	15 (27.3)	21 (30.9)
TNM stage, n (%)			0.235
0	14 (25.5)	13 (19.1)
I	16 (29.1)	11 (16.2)
II	14 (25.5)	21 (30.9)
III	10 (18.1)	22 (32.4)
IV	1 (1.8)	1 (1.4)

RRH: Robotic right hemicolectomy; LRH: Laparoscopic right hemicolectomy; BMI: Body mass index; IQR: Interquartile range; TNM: Tumor node metastasis; ASA: American Society of Anesthesiologists; ACCI: Age-adjusted Charlson Comorbidity Index.

Table 2 Intra-operative variables

	RRH (n = 55)	LRH (n = 68)	P value
Operative time (min), median (IQR)	198 (160-231)	142 (116.5 -171.5)	< 0.001
Conversion, n (%)	5 (9.0)	3 (4.4)	0.295
Intra-operative complication, n (%)	1 (1.8)	0 (0.0)	0.264
Retrieved lymph-nodes median, (IQR)	27 (21-41)	27 (21-36.5)	0.663

RRH: Robotic right hemicolectomy; LRH: Laparoscopic right hemicolectomy; IQR: Interquartile range.

Table 3 Post-operative outcomes

	RRH (n = 55)	LRH (n = 68)	P value
Hospital stay (d), median (IQR)	6 (5-8)	7 (6-10.5)	0.028
Time to first flatus (d), median (IQR)	2 (1-3)	3 (2-4)	< 0.001
Time to first stool (d), median (IQR)	4 (3-5)	5 (4-6.5)	0.005

RRH: Robotic right hemicolectomy; LRH: Laparoscopic right hemicolectomy; IQR: Interquartile range.

Table 4 Post-operative complications, n (%)

	RRH (n = 55)	LRH (n = 68)	P value
Reintervention	1 (1.8)	4 (5.8)	0.256
Readmission	2 (3.6)	2 (2.9)	0.829
Urinary retention	1 (1.8)	1 (1.4)	0.880
Ileus	1 (1.8)	11(16.1)	0.008
Wound Infection	0 (0.0)	5 (7.3)	0.040
Acute bleeding	3 (5.4)	7 (10.2)	0.329
Hematoma	3 (5.4)	2 (2.9)	0.483
Abdominal abscess	3 (5.4)	4 (5.8)	0.919
Anastomotic leak	2 (3.6)	4 (5.8)	0.565
Respiratory complication	0 (0.0)	4 (5.8)	0.067
Pleural effusion	2 (3.6)	6 (8.8)	0.246
Atrial fibrillation	2 (3.6)	2 (2.9)	0.829
Total complications	17 (30.9)	23 (33.8)	0.732
Mortality 180 d	0 (0)	0 (0)	-

RRH: Robotic right hemicolectomy; LRH: Laparoscopic right hemicolectomy.

Table 5 Post-operative complications according to Clavien-Dindo classification

	RRH (n = 55)	LRH (n = 68)	P value
Clavien-Dindo grade, n (%)
0	39 (70.9)	45 (66.2)	0.760
1	4 (7.3)	6 (8.8)
2	9 (16.4)	13 (19.1)
3	1 (1.8)	0 (0.0)
4	2 (3.6)	4 (5.9)
Clavien-Dindo grade, n (%)
0	43 (78.2)	51 (75)	0.679
≥ 1	12 (21.8)	17 (25)

RRH: Robotic right hemicolectomy; LRH: Laparoscopic right hemicolectomy.

Table 6 Multivariable regression model of length of stay

	β coefficient	95%CI	P >|t|
Robotic technique	1.887	0.077-3.698	0.041
Age ≥ 75 yr	2.147	0.314-3.980	0.022
ACCI ≥ 7	2.807	0.485-5.130	0.018

R² = 0.1471, P > F = 0.031.

Table 7 Multivariable regression model of time to first flatus

	β coefficient	95%CI	P >|t|
Robotic technique	1.183	0. 565-1.801	0.000
Age ≥ 75 yr	1.009	0.314-1.703	0.005

R² = 0.1579, P > F = 0.0006.

Table 8 Multivariable regression model of time to first stool

	β coefficient	95%CI	P >|t|
Robotic technique	1.063	0.337-1.789	0.004
Age ≥ 75 yr	0.939	0.165-1.713	0.018

R² = 0.1059, P > F = 0.0075.

Table 9 Post-operative outcomes sorted by age </≥ 75 yr and ACCI </≥ 7

	Age < 75 yr (n = 76)	Age ≥ 75 yr (n = 47)	P value	ACCI < 7 (n = 87)	ACCI ≥ 7 (n = 36)	P value
Hospital stay (d), median (IQR)	6 (5-8)	7 (6-12)	0.013	7 (5-8)	7 (6-14.5)	0.036
Time to first flatus (d), median (IQR)	2 (1-3)	3 (2-4)	0.008	2 (1-3)	2.5 (2-3.5)	0.079
Time to first stool (d), median (IQR)	5 (4-6)	5 (4-7)	0.062	5 (4-6)	5 (4-7)	0.084

IQR: Interquartile range.