Comparison of short‐term outcomes and perioperative costs in laparoscopic versus robotic surgery for rectal cancers: A real‐world cohort study using Japanese nationwide inpatient database
2025

Comparing Laparoscopic and Robotic Surgery for Rectal Cancer

Sample size: 1396 publication 10 minutes Evidence: moderate

Author Information

Author(s): Hamamoto Hiroki, Ota Masato, Shima Takafumi, Kuramoto Toru, Kitada Kazuya, Taniguchi Kohei, Asakuma Mitsuhiro, Oura Yasuhiro, Ito Yuri, Lee Sang‐Woong

Primary Institution: Osaka Medical and Pharmaceutical University

Hypothesis

This study aimed to compare the short-term outcomes and perioperative costs of laparoscopic and robotic surgery for rectal cancer using a real-world database.

Conclusion

Robotic surgery was associated with better outcomes than laparoscopic surgery in terms of surgical site infection and respiratory failure rates, but the total medical costs were comparable.

Supporting Evidence

  • The robotic group had a lower surgical site infection rate (2.9% vs. 1.5%, p=0.010).
  • The robotic group had a lower respiratory failure rate (1.3% vs. 0.6%, p=0.049).
  • The operative medical costs of robotic surgery were significantly higher than those of laparoscopic surgery (1,312,462 vs. 1,291,371 JPY, p=0.013).
  • There was no significant difference in the total medical costs between robotic and laparoscopic surgery (1,895,822 vs. 1,862,439 JPY, p=0.051).

Takeaway

Doctors compared two types of surgery for rectal cancer to see which one is better and found that robotic surgery has fewer infections, but costs more.

Methodology

The study analyzed data from patients who underwent laparoscopic or robotic surgery for rectal cancer between January 2018 and January 2021, using propensity score matching to compare outcomes.

Potential Biases

The criteria for defining main diseases may be open to interpretation, potentially affecting the results.

Limitations

The DPC dataset did not include important information such as intraoperative and histological outcomes, and the learning curves of the surgeons may not have been considered.

Participant Demographics

The study included patients who underwent laparoscopic or robotic surgery for rectal cancer, with a mix of male and female participants.

Statistical Information

P-Value

p=0.051

Confidence Interval

95% CI; −3374 to −1723$

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1002/ags3.12884

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