Is Robotic Complete Mesocolic Excision Feasible for Transverse Colon Cancer?

Abstract

Introduction: Laparoscopic complete mesocolic excision (CME) for transverse colon cancer is technically challenging. Robotic technology has been developed to reduce technical limitations of laparoscopy. Yet, no data are available on the role of robotic approach for CME of transverse colon cancer. The aim of this study is to evaluate the feasibility and short-term outcomes of robotic CME in this subset of colon cancer. Methods: A retrospective review of a prospectively maintained database of 29 consecutive patients undergoing robotic CME for transverse colon adenocarcinoma between December 2014 and December 2017 was performed. Data on demographics, tumor characteristics, postoperative 30-day complications, and oncologic outcomes were analyzed. Results: There were 21 (72%) men and 8 women with a mean age of 62.915.6 years and a body mass index of 26.4 +/- 4.8kg/m(2). Of the 29 robotic CME procedures, 12 patients underwent extended right colectomy, 10 extended left colectomy, 6 subtotal colectomy, and 1 total colectomy. The mean operative time was 321.7 +/- 111.3 minutes and estimated blood loss was 106.9 +/- 110.9mL (median, 50; range, 10-400mL). The intra- and postoperative complication rates were 7% and 24%, respectively. There were no conversions. The mean time to first bowel movement was 3.5 +/- 1.3 and length of hospital stay was 7.1 +/- 3.0 days. All the resections were R0. The mean number of harvested lymph nodes in extended and subtotal/total colectomy procedures was 36.6 +/- 13.1 and 71.0 +/- 30.3, respectively. The rate of mesocolic plane surgery was 79%. There were no statistically significant differences between the mesocolic and the intramesocolic/muscularis propria plane resections with respect to clinical characteristics, operative outcomes, and pathology results (P>.05). Conclusions: Robotic CME for transverse colon cancer is feasible and can be a procedure of choice to achieve a good surgical quality.