Robotic left colectomy with complete mesocolectomy for splenic flexure and descending colon cancer, compared with a laparoscopic procedure

Abstract

BACKGROUND: Its relatively low incidence and its surgical complexity mean that a standardized technique for left colectomy has not yet been established for splenic flexure and descending colon cancer (SF-DCC). METHODS: Seventy-three patients (robot-assisted left colectomy with complete mesocolectomy [R-LCCM], n = 20; laparoscopic left colectomy with complete mesocolectomy [L-LCCM], n = 53) with SF-DCC were enrolled at the Asan Medical Center (Seoul, Korea). RESULTS: R-LCCM conveniently enables dexterous dissection for the multi-directional approaches during left mesocolic mobilization. A conversion to open surgery was required in two patients of the L-LCCM group, but not in the R-LCCM group. A positive circumferential resection margin was exclusively identified in two patients in the L-LCCM group. Mean lymph node harvest was 21 with no difference between the two groups. CONCLUSIONS: Although R-LCCM provided few remarkable advantages over L-LCCM, it could be considered as an efficient approach in patients with SF-DCC.