Short‐Term Outcomes of Robot‐Assisted Versus Laparoscopic Colectomy for Colon Cancer: A Propensity Score‐Matched Analysis

ABSTRACT Aim Clinical benefits of robot‐assisted colectomy over laparoscopic colectomy for colon cancer remain uncertain, and real‐world data are limited. We evaluated the short‐term outcomes of robot‐assisted colectomy versus laparoscopic colectomy in patients with colon cancer. Methods This single‐center, retrospective cohort study evaluated patients who underwent minimally invasive colectomies for colon cancer at Osaka General Medical Center from January 2014 to November 2024. Short‐term outcomes were compared after 1:1 propensity score matching to minimize confounding by indication. Results In total, 480 patients underwent laparoscopic colectomies and 282 underwent robot‐assisted colectomies, with 218 matched pairs. Baseline characteristics were well‐balanced. Surgical procedure distribution was similar between the groups ( P = 0.897). Mean operative times were significantly longer (212 vs. 200 min, P = 0.040), mean intraoperative blood loss was significantly lower (22.8 vs. 37.5 mL, P < 0.001), rates of conversion to open surgery were significantly lower (0.0% vs. 2.3%, P = 0.026), and mean hospital stays were significantly shorter (7.0 vs. 11.3 d, P < 0.001) in the robot‐assisted colectomy group. The number of lymph node dissections ( P = 0.27) and local R0 resection rates ( P = 0.34) were comparable. Overall complication rates were significantly lower in the robot‐assisted colectomies (11.0% vs. 17.9%, P = 0.007), whereas clinically meaningful complication rates (Clavien–Dindo grades ≥ II) were comparable ( P = 0.150). Conclusions These findings provide real‐world data supporting the feasibility of robot‐assisted colectomy for colon cancer treatment. Further research should evaluate the long‐term oncologic outcomes and cost‐effectiveness.