Wickramasinghe, Shehan, Klein, Kerenaftali, Pornkul, Panuwat, Mushaya, Chrispen, Larson, David, and Sakata, Shinichiro (2025) Days at Home up to 30 Days After Robotic Versus Laparoscopic Colorectal Surgery. Diseases of the Colon & Rectum, 68 (10). pp. 1207-1214.

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Abstract

BACKGROUND: “Days at home up to 30 days” is a novel patient-centered outcome metric that measures the number of days patients spend at home 30 days after surgery. It encompasses inpatient stay from index admission, interhospital transfers and step-downs, and readmissions across different hospitals. OBJECTIVE: Comparison of days at home up to 30 days and established outcome metrics after robotic versus 3-dimensional laparoscopic surgery. DESIGN: Prospective cohort study of consecutive patients. SETTING: Townsville University Hospital and Mater Private Hospital, Townsville, Queensland, Australia. PATIENTS: Adult patients undergoing robotic and 3-dimensional laparoscopic colorectal surgery. MAIN OUTCOME MEASURES: Days at home up to 30 days, 30-day readmission rate, index admission length and 30-day postoperative complication rates. RESULTS: Of 82 patients, 32 (39%) underwent robotic, and 50 (61%) underwent 3-dimensional laparoscopic colorectal surgery. Robotic ultra-low and low anterior resection, as well as abdominoperineal resection resulted in significantly more days at home (23 vs 15 days at home, p = 0.05) and lower length of index admission (7 vs 15 days in hospital, p = 0.0003). However, there was no significant difference in major postoperative complications and 30-day readmission rate. No significant differences between robotic and 3-dimensional laparoscopic right hemicolectomy, as well as high anterior resection were found. LIMITATIONS: Unrandomized study. Patient selection for robotic and 3-dimensional laparoscopic surgery was at the surgeons’ discretion. CONCLUSION: Patients undergoing robotic ultra-low and low anterior resection, as well as abdominoperineal resection spent more days at home 30-days post-index surgery due to a reduction in the length of the index hospital admission. Days at home up to 30 days may enhance the informed consent and complement traditional endpoints in future clinical trials.

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