微创手术越来越多地应用于局部晚期结肠癌的治疗。然而，缺乏比较机器人 (RRC) 与腹腔镜右结肠切除术 (LRC) 治疗非转移性 pT4 癌症的证据。这是一项多中心倾向评分匹配 (PSM) 研究，对象为接受 RRC 或 LRC 治疗的 pT4 右结肠癌连续患者队列。比较两种手术方法的 R0、淋巴结获取数量、术中和术后并发症发生率、总生存期 (OS) 和无病生存率 (DFS)。 在总共 200 名患者中，39 名 RRC 与78 名 PS 匹配的 LRC 患者。 RRC 和 LRC 之间的 R0 率相似（分别为 92.3% 与 96.2%；p = 0.399），检索 12 个或更多淋巴结的几率也相似（97.4% 与 96.2%；p = 1）。平均操作时间没有显着差异（192.9 分钟与 198.3 分钟；p=0.750）。然而，RRC 与较少的剖腹手术转换（5.1% vs. 20.5%；p = 0.032）、较少的失血量（36.9 vs. 95.2mL；p< 0.0001）、较少的术后并发症（17.9% vs. 41%；p）相关。 = 0.013），与 LRC 相比，排气时间更短（2 天 vs. 2.8  天；p = 0.009），住院时间更短（6.4 天 vs. 9.5 天；p< 0.0001）。即使转换后的程序被排除在分析之外，这些结果也得到了证实。 RRC 和 LRC 之间的 1 年、3 年和 5 年 OS (p = 0.757) 和 DFS (p = 0.321) 没有显着差异。针对 pT4 右结肠癌进行的 RRC 和 LRC 观察到了足够的肿瘤学结果。然而，RRC 与较低的转换率和改善的短期术后结果相关。© 2024 作者。约翰·威利出版的《结直肠疾病》

Minimally invasive surgery has been increasingly adopted for locally advanced colon cancer. However, evidence comparing robotic (RRC) versus laparoscopic right colectomy (LRC) for nonmetastatic pT4 cancers is lacking.This was a multicentre propensity score-matched (PSM) study of a cohort of consecutive patients with pT4 right colon cancer treated with RRC or LRC. The two surgical approaches were compared in terms of R0, number of lymph nodes harvested, intra- and postoperative complication rates, overall (OS), and disease-free survival (DFS).Among a total of 200 patients, 39 RRC were compared with 78 PS-matched LRC patients. The R0 rate was similar between RRC and LRC (92.3% vs. 96.2%, respectively; p = 0.399), as was the odds of retrieving 12 or more lymph nodes (97.4% vs. 96.2%; p = 1). No significant difference was noted for the mean operating time (192.9 min vs. 198.3 min; p = 0.750). However, RRC was associated with fewer conversions to laparotomy (5.1% vs. 20.5%; p = 0.032), less blood loss (36.9 vs. 95.2 mL; p < 0.0001), fewer postoperative complications (17.9% vs. 41%; p = 0.013), a shorter time to flatus (2 vs. 2.8 days; p = 0.009), and a shorter hospital stay (6.4 vs. 9.5 days; p < 0.0001) compared with LRC. These results were confirmed even when converted procedures were excluded from the analysis. The 1-, 3- and 5-year OS (p = 0.757) and DFS (p = 0.321) did not significantly differ between RRC and LRC.Adequate oncological outcomes are observed for RRC and LRC performed for pT4 right colon cancer. However, RRC is associated with lower conversion rates and improved short-term postoperative outcomes.© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.