ArticleSurgical endoscopy2026
Robot-assisted colectomy is associated with improved perioperative outcomes and favorable survival in stage I-III colon cancer: a nationwide overlap-weighted analysis.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundRobot-assisted colectomy has been increasingly adopted for colon cancer because of its technical advantages; however, evidence regarding its short- and survival oncological outcomes remains limited. The aim of this study was to compare short- and survival outcomes among open, laparoscopic, and robot-assisted colectomy (OC, LC, and RAC) for stage I-III colon cancer using a large real-world database.
methodsThis multicenter retrospective cohort study analyzed 43,540 patients with clinical stage I-III colon cancer who underwent colectomy between April 2022 and September 2025 using the Japanese Medical Data Vision database. To adjust for baseline differences across surgical approaches, overlap weighting was applied, yielding an effective sample size of 34,236 patients. Primary outcomes included postoperative complications, perioperative mortality, length of hospital stay, and hospitalization costs. Secondary outcomes were overall survival (OS) and recurrence-free survival (RFS).
resultsAfter overlap weighting, 3,694 patients underwent RAC, 25,975 underwent LC, and 4,567 underwent OC. The RAC group demonstrated the lowest rates of postoperative complications, intraoperative blood transfusion, and 30- and 90-day mortality, as well as the shortest hospital stay and lowest hospitalization costs. The 3-year OS rates were 95, 94, and 90% in the RAC, LC, and OC groups, respectively (p < 0.001), with corresponding RFS rates of 94, 92, and 88%.
conclusionsCompared with LC and OC, RAC for stage I-III colon cancer was associated with favorable short-term outcomes and survival profiles. Prospective studies with longer follow-up are warranted to clarify its survival oncological impact.
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