Lower need for allogeneic blood transfusion after robotic low anterior resection compared with open low anterior resection: a propensity score-matched analysis

Robotic low anterior resection (R-LAR) for rectal cancer may decrease estimated blood loss compared with open low anterior resection (O-LAR).

The aim of this study was to compare estimated blood loss and blood transfusion within 30 days after O-LAR and R-LAR.

This was a retrospective matched cohort study based on prospectively registered data from Västmanland Hospital, Sweden.

The first 52 patients operated on using R-LAR for rectal cancer at Västmanland Hospital were propensity score-matched 1:2 with patients who underwent O-LAR for age, sex, ASA (American Society of Anesthesiology physical classification system), and tumor distance from the anal verge.

In total, 52 patients in the R-LAR group and 104 patients in the O-LAR group were included.

Estimated blood loss was significantly higher in the O-LAR group compared with R-LAR: 582.7 ml (SD ± 489.2) vs. 86.1 ml (SD ± 67.7); p  < 0.001.

Within 30 days after surgery, 43.3% of patients who received O-LAR and 11.5% who received R-LAR were treated with blood transfusion ( p  < 0.001).

As a secondary post hoc finding, multivariable analysis identified O-LAR and lower pre-operative hemoglobin level as risk factors for the need of blood transfusion within 30 days after surgery.

Patients who underwent R-LAR had significantly lower estimated blood loss and a need for peri- and post-operative blood transfusion compared with O-LAR.

Open surgery was shown to be associated with an increased need for blood transfusion within 30 days after low anterior resection for rectal cancer.