AB098. SOH26AB_0244. Robotic right hemicolectomy: a cohort study on outcomes of intracorporeal anastomosis vs. extracorporeal anastomosis

Background: Robotic right hemicolectomy (RRH) is an established approach for right-sided colonic pathology. Extracorporeal anastomosis (ECA) remains standard for laparoscopic and some robotic surgeons, but the robotic platform readily facilitates intracorporeal anastomosis (ICA). This study aimed to compare outcomes in patients with colon cancer undergoing RRH, with ECA or ICA, in a tertiary hospital.

Methods: A retrospective cohort study, derived from a prospectively maintained robotic colorectal surgery database, comparing RRH with ECA vs. ICA between July 2019 and March 2025.

Results: In total, 62 patients were identified, of which 70.9% (n=44) underwent RRH with ECA and 29.1% (n=18) with ICA. Cohorts were comparable regarding sex distribution, age, body mass index, and American Society of Anaesthesiologists grade. There was a higher incidence of postoperative complications in the ECA compared with the ICA cohort (43.2% vs. 27.8%); however, this was not statistically significant [relative risk (RR) =1.55; 95% confidence interval (CI): 0.69–3.52; P=0.26]. Surgical site infection (SSI) was the most common complication with an incidence of 22.7% (n=10) in ECA and 5.5% (n=1) in ICA cohorts, respectively (RR =4.09; 95% CI: 0.56–29.6; P=0.15). There were no significant differences in operation duration, estimated blood loss, length of stay, 30-day reoperation rate, or 30-day mortality.

Conclusions: The results illustrate that RRH with ICA is a safe, minimally invasive alternative to ECA, with overall comparable outcomes and a trend to reduced incidence of postoperative morbidity, especially SSI, in the ICA cohort.

Keywords: Cohort; colorectal surgery; intracorporeal anastomosis (ICA); postoperative outcomes; robotic right hemicolectomy (RRH)