Comparative analysis of surgical inflammatory response with c reactive protein post robotic vs laparoscopic elective colorectal resection for colorectal tumour

Background It is postulated that robotic colorectal surgery (RCS) via stable three-dimensional visual field, precise dissection and tremor suppression are associated with less tissue trauma and improved postoperative outcomes compared to laparoscopic colorectal surgery (LCS). We characterised the inflammatory response by measuring postoperative c reactive protein (CRP) levels after RCS and compared them after LCS reported in the literature. Methods Single centre, single surgeon retrospective study of consecutive elective robotic colon and rectum resections using the da Vinci® Xi platform for benign and malignant colorectal tumours between January 2017-December 2023. CRP values were measured at postoperative day (POD) 3 and 5. Literature review was performed using EMBASE and MEDLINE via Pubmed from inception to December 2024. Results One hundred ninety-three patients were identified in the RCS cohort. Median age was 73 (range: 62–83). Most of the colectomies were performed for adenocarcinoma (90.2%) with right hemicolectomy being the most common type of procedure (49.3%). The median CRP on POD 3 and 5 were 83.10 mg/L (IQR: 49.80-124.12) and 26.20mg/L (IQR: 17.70–80.00), respectively. The reporting of CRP after LCS was heterogeneous, with mean POD 3 values between 69-99.5mg/L, and mean POD 4–5 values between 62.4-72.85mg/L. Conclusions There were similar, if not lower POD3 and 5 CRP values to suggest that RCS was at least non-inferior to LCS regarding postoperative tissue trauma. In particular, RCS appeared to have a relatively quicker subsidence of the inflammatory response between POD 3–5. RCS may reduce surgical tissue trauma, and correlate with improved postoperative outcomes.