Short-term outcomes of single-port robotic surgery versus single-port laparoscopic surgery for colon cancer: a multicenter matched-cohort analysis

Background: Single-port laparoscopic surgery (SPLS) improves patient comfort; however, it has limitations, including poor instrument triangulation. The da Vinci® SP system used in single-port robotic surgery (SPRS) addresses these challenges. Most studies on SPRS involve small case series or comparisons with multiport procedures, usually lacking direct comparisons with SPLS for colon cancer. Therefore, this study aimed to evaluate the surgical outcomes of SPRS and compare its short-term results with those of SPLS for colon cancer. Methods: This study included patients who underwent SPRS for colon cancer between March 2019 and April 2023 at four tertiary referral centers. Medical records of these patients were reviewed. Eligible patients were aged 19–85 years, with American Society of Anesthesiologists class I or II, and confirmed adenocarcinoma of the ascending or sigmoid colon without distant metastasis. The data obtained were compared with those of the SPLS cohort from the SIngle-port versus MultiPort Laparoscopic surgEry multicenter randomized trial. A matched cohort analysis accounted for baseline differences. Results: Overall, 185 and 179 patients were included in the SPRS and SPLS groups, respectively. After matching, 95 and 86 patients who underwent SPRS and SPLS, respectively, were analyzed with balanced baseline characteristics. SPRS was associated with less blood loss, lower conversion rates, fewer intraoperative complications, and faster recovery, including earlier diet resumption and shorter hospital stays, than SPLS. Conclusions: SPRS provides superior perioperative advantages over SPLS, including reduced blood loss, lower conversion rates, fewer complications, and faster recovery. These findings highlight SPRS as a promising option for minimally invasive colorectal surgery, pending further validation to confirm these benefits and ensure long-term efficacy.