Evaluation of surgical stress after colorectal interventions: a multicenter randomized clinical trial of robotic versus laparoscopic surgery

A major factor in the development of morbidity after surgery is the surgical stress response. The aim of this interventional multicenter randomized open label, parallel group trial is to evaluate the possible lower inflammatory stress response induced by robot-assisted versus laparoscopic surgery for colorectal resections. A total of 593 patients diagnosed with colorectal cancer planned for elective, curative surgery was screened for eligibility. 314 patients planned for right colectomy, left colectomy or rectal resection were randomly assigned 1:1 to robotic (n = 161) or laparoscopic group (n = 153). The primary endpoint was the 24-hours postoperative ∆% change of IL-6 serum levels. Subgroup analyses included the assessment of IL-6 ∆% changes stratified according to age, obesity, comorbidities, tumor staging and resection type have been also performed. In conclusion robotic surgery was associated to a lower surgical stress after colorectal surgery and this finding may help in decision-making regarding when to proceed to robotic approach for colorectal cancer, especially in selected high risk clinical settings.