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Background <p>This retrospective cohort study, based on a national administrative database, compared postoperative outcomes between robotic-assisted and laparoscopic colorectal cancer (CRC) surgery in patients with heart failure (HF).</p> Methods <p>We conducted a retrospective cohort study using the 2016–2020 Nationwide Readmissions Database (NRD). Adult patients with CRC and pre-existing HF who underwent elective laparoscopic or robotic-assisted surgery were included. Patients with metastatic disease or those who underwent open surgery were excluded. Primary outcomes were in-hospital mortality and major postoperative complications, including acute kidney injury (AKI), venous thromboembolism (VTE), cardiac and cerebrovascular events, and respiratory failure. Secondary outcomes included prolonged length of hospital stay (LOS) and 30- and 90-day readmission rates. Multivariable logistic regression accounting for the NRD’s complex sampling design was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs), with statistical significance set at <i>p</i> &lt; 0.05.</p> Results <p>Data from a total of 1,380 patients were analyzed. Patients who underwent robotic-assisted surgery had a significantly higher incidence of acute kidney injury (AKI) compared with those who underwent conventional laparoscopic surgery (23.0 vs. 17.0%, <i>p</i> = 0.018). In multivariable logistic regression analysis, robotic-assisted surgery remained independently associated with an increased risk of AKI (adjusted odds ratio [aOR] = 1.52; 95% CI 1.10–2.09; <i>p</i> = 0.010). Robotic-assisted surgery was associated with a significantly higher risk of acute kidney injury (AKI) compared to laparoscopic surgery (adjusted odds ratio [aOR] = 1.52; 95% CI 1.10–2.09; <i>p</i> = 0.010).</p> Conclusions <p>In patients with HF undergoing minimally invasive CRC surgery, robotic-assisted surgery was associated with a higher risk of AKI but a similar length of hospital stay (LOS) and readmission rates compared to laparoscopic surgery. These findings underscore the need for careful perioperative management and individualized surgical planning in this high-risk population.</p>

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Comparison of outcomes between robot-assisted and laparoscopic colorectal cancer surgery in patients with heart failure: a national readmission database analysis

  • 期刊论文

  • 发表日期：

    2026年7月31日

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  • Yu-Shih Liu,
  • Pi-Kai Chang

摘要

Background

This retrospective cohort study, based on a national administrative database, compared postoperative outcomes between robotic-assisted and laparoscopic colorectal cancer (CRC) surgery in patients with heart failure (HF).

Methods

We conducted a retrospective cohort study using the 2016–2020 Nationwide Readmissions Database (NRD). Adult patients with CRC and pre-existing HF who underwent elective laparoscopic or robotic-assisted surgery were included. Patients with metastatic disease or those who underwent open surgery were excluded. Primary outcomes were in-hospital mortality and major postoperative complications, including acute kidney injury (AKI), venous thromboembolism (VTE), cardiac and cerebrovascular events, and respiratory failure. Secondary outcomes included prolonged length of hospital stay (LOS) and 30- and 90-day readmission rates. Multivariable logistic regression accounting for the NRD’s complex sampling design was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs), with statistical significance set at p < 0.05.

Results

Data from a total of 1,380 patients were analyzed. Patients who underwent robotic-assisted surgery had a significantly higher incidence of acute kidney injury (AKI) compared with those who underwent conventional laparoscopic surgery (23.0 vs. 17.0%, p = 0.018). In multivariable logistic regression analysis, robotic-assisted surgery remained independently associated with an increased risk of AKI (adjusted odds ratio [aOR] = 1.52; 95% CI 1.10–2.09; p = 0.010). Robotic-assisted surgery was associated with a significantly higher risk of acute kidney injury (AKI) compared to laparoscopic surgery (adjusted odds ratio [aOR] = 1.52; 95% CI 1.10–2.09; p = 0.010).

Conclusions

In patients with HF undergoing minimally invasive CRC surgery, robotic-assisted surgery was associated with a higher risk of AKI but a similar length of hospital stay (LOS) and readmission rates compared to laparoscopic surgery. These findings underscore the need for careful perioperative management and individualized surgical planning in this high-risk population.