Annals of Coloproctology

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Minimally invasive surgery

Interim analysis of short-term outcomes between robotic and laparoscopic surgery for colon cancer: results from the ESSIMIC trial: Marco Milone, Sara Vertaldi, Pietro Anoldo, Simona Borin, Graziano Ceccarelli, Anna D’Amore, Maurizio Degiuli, Paolo Delrio, Uberto Romario Fumagalli, Mario Guerrieri, Michele Manigrasso, Monica Ortenzi, Ugo Pace, Felice Pirozzi, Lucia Puca, Wanda Petz, Rossella Reddavid, Daniela Rega, Fabio Rondelli, Antonio Sciuto, Giovanni Domenico De Palma; Ann Coloproctol. 2026;42(1):86-93. Published online February 23, 2026; DOI: https://doi.org/10.3393/ac.2025.00339.0048

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Graphical Abstract Abstract PDF Supplementary Material: Purpose
This study aimed to determine whether the benefits of robotic surgery can be applied to the treatment of colon cancer by evaluating short-term outcomes of robotic versus laparoscopic colonic resection.
Methods
This interim analysis of an interventional multicenter randomized trial was conducted to compare outcomes of robotic and laparoscopic colorectal surgery performed between January 2017 and December 2019. The study specifically assessed short-term outcomes in patients undergoing laparoscopic or robotic right or left colectomy for cancer. In addition, all short-term outcomes were evaluated in separate subgroups of right and left colonic resections through prespecified subgroup analyses.
Results
A total of 323 patients were analyzed, of whom 142 underwent robotic-assisted surgery and 181 underwent laparoscopic surgery. Overall, 109 complications (33.7%) occurred in the short-term period, 41 (28.9%) in the robotic group and 68 (37.6%) in the laparoscopic group, with no differences between groups in intraoperative or postoperative complications. However, grade III complications were significantly more frequent in the laparoscopic group, with 17 cases (9.4%) compared to 5 cases (3.5%) in the robotic group. Oncological radicality was similar between groups. Functional recovery after surgery was superior in the robotic group, as reflected by a shorter time to mobilization (17.5±10.2 hours vs. 21.1±11.5 hours). In the right colectomy subgroup, rates of grade III complications (1.9% vs. 11.7%) and lymph nodes retrieved (20.3±10.3 vs. 20.2±6.4) favored robotic surgery. In the left colon cancer subgroup, functional recovery was also improved with robotic surgery (44.3±22.2 hours vs. 61.1±31.1 hours, as measured by the composite recovery outcome).
Conclusion
Robotic surgery is associated with fewer severe complications and improved postoperative recovery following colonic resections. Trial registration: ClinicalTrials.gov identifier: NCT02871960

Complications

Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study: Daniela Rega, Ernesto De Giulio, Raffaele De Luca, Andrea Muratore, Marco Milone, Giuseppe Sica, Paolo Millo, Carmela Cervone, Nicola Cillara, Patrizia Marsanic, Brunella Maria Pirozzi, Valeria Grazia Malagnino, Pietro Anoldo, Marcello Calabrò, Giovanni De Palma, Michele Simone, Paolo Delrio; Ann Coloproctol. 2025;41(4):293-302. Published online June 4, 2025; DOI: https://doi.org/10.3393/ac.2024.00899.0128

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Graphical Abstract Abstract PDF

Purpose
Anastomotic leaks (AL) remain a major complication following right colectomy for colon cancer. This multicenter, prospective, observational study evaluated the efficacy of Glubran 2, a cyanoacrylate-based sealant, in reducing the incidence of AL by reinforcing ileocolic anastomoses.
Methods
The study enrolled 380 patients undergoing right colectomy for colon cancer across 7 Italian hospitals. Glubran 2 was applied to reinforce ileocolic anastomoses. The primary endpoint was a 50% reduction in AL incidence from a baseline of 6.18% within 10 days after surgery. Secondary endpoints included examining the correlation between AL and preexisting risk factors and determining the rate of anastomotic bleeding. Statistical analyses employed binomial tests and logistic regression.
Results
The AL rate was reduced to 1.85% compared to the reference rate of 6.18% (P<0.01). Glubran 2 exhibited a protective effect even in patients with preexisting risk factors such as smoking, diabetes, or prior surgeries; none of these factors was significantly associated with AL (P>0.05). Surgical technique (P=0.687), anastomosis technique (P=0.998), and anastomosis type (P=0.998) did not influence AL rates. Operation time was similar across groups (P=0.613), and anastomotic bleeding occurred in 1.3% of cases, with no association with AL (P=0.989).
Conclusion
Glubran 2 was safely applied to ileocolic anastomoses, significantly reducing AL rates and potentially providing a protective effect even in patients with known risk factors. Its hemostatic and bacteriostatic properties support improved postoperative outcomes, highlighting its potential as an effective adjunct in colorectal surgery. Further studies are warranted to confirm these findings and explore broader applications.

Citations

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Comments on “Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study”
Nabil Mohammad Azmi, Mohd Firdaus Mohd Hayati, Zairul Azwan Mohd Azwan
Annals of Coloproctology.2025; 41(6): 596. CrossRef
In reply to: Comments on "Improved outcomes with cyanoacrylate glue for ileocolic anastomosis in right colectomy: a multicenter study”
Daniela Rega, Carmela Cevone, Paolo Delrio
Annals of Coloproctology.2025; 41(6): 598. CrossRef

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