Search Results (151)

Background and Objectives: We compared mini-laparoscopic and laparoscopic hysterectomy in terms of surgery duration, postoperative pain, conversion rate, blood loss, postoperative complications (Clavien-Dindo classification), and the length of hospital stay. Materials and Methods: Patients were recruited between 1 January 2017 and 1 January 2024, at the Department of Gynecology, “Villa Sofia-Cervello” Hospital. Indications for hysterectomy included uterine myoma, endometriosis, endometrial hyperplasia, adenomyosis, high-grade cervical dysplasia, early-stage endometrial cancer, and microinvasive cervical cancer. Patients were divided according to treatment into conventional laparoscopic hysterectomy (LH) with all 5 mm ports or the needlescopic approach (minilaparoscopic hysterectomy [MLH]), using 3 mm instruments. Postoperative pain was assessed using the visual analog scale (VAS) at multiple time points (2, 6, 12, and 24 h post-surgery). Results: A total of 308 patients were enrolled, with 153 women in the LH group and 155 in the MLH group. The surgery duration was on average 105.5 min in LH and 98.8 min in MLH (p < 0.0001). The intraoperative blood loss averaged 195.1 mL in LH and 100.3 mL in MLH (p < 0.001). The average length of hospital stay was 4.0 days for women undergoing LH compared to 3.2 days for women undergoing MLH (p < 0.001). Conclusions: This retrospective study demonstrated that MLH is an effective and functional technique for treating various gynecological conditions, with advantages in terms of aesthetic outcomes and reduced perioperative pain and recovery times. The positive results, supported by key parameters such as surgical duration, blood loss, and complications, could serve as a foundation for future studies on larger populations and for improving clinical practices in gynecology. Full article

Background: Cardiovascular diseases (CVD) are recognized as a leading cause of morbidity and mortality in the population worldwide. A healthy cardiovascular system enables adaptation to trauma and physical stress. This study targets the reciprocal relation between CVD and postoperative complications after trauma surgery. Methods: In 2014, a randomized and standardized acquisition of study patients was initiated at a Level I trauma center in Germany. The burden of CVDs and the location, type, and severity of injuries were categorized. Clavien–Dindo classification was used to record postoperative complications. Results: The study analyzed a cohort of 1262 patients, representing a diverse range of orthopedic treatment disciplines within the hospital. It highlighted that patients with lower leg fractures experienced significantly higher complication rates, particularly linked to heart valve diseases and chronic venous insufficiency. Age and sex were not found to have a significant impact. Multivariate analysis identified additional key influencing factors for the development of complications, including the number of CVDs, nutritional status, smoking habits, and mobility levels. Conclusions: CVDs play a pivotal role in elevating complication rates post-trauma-surgery. Trauma-related extremity conditions are notably more severe when accompanied by CVD. A personalized approach that accounts for cardiovascular risk factors could significantly improve treatment outcomes in the future. Full article

Background/Objectives: Early-onset scoliosis (EOS) frequently requires growth-friendly interventions, such as magnetically controlled growing rods (MCGRs), followed by definitive spinal fusion upon skeletal maturity. The optimal implant density (ID) for final posterior spinal fusion in these patients remains controversial. This study aimed to compare the radiographic, surgical, and economic outcomes associated with high-density (HD) versus low-density (LD) screw constructs in EOS patients previously treated with MCGRs undergoing definitive fusion. Methods: This retrospective study included 27 EOS patients who underwent definitive posterior spinal fusion between January 2017 and September 2022. Participants were categorized into two groups: HD (n = 13) and LD (n = 14). Primary outcomes included coronal and sagittal radiographic parameters assessed at early postoperative and final follow-up visits (minimum of 2 years). The secondary outcomes analyzed were major postoperative complications (grade ≥ IIIB according to Clavien–Dindo–Sink Classification [CDSC]), operative time, blood loss, hospital stay length, and total implant costs. Results: Baseline characteristics between the HD and LD groups were comparable. Early postoperative radiographic assessment demonstrated significantly greater thoracic kyphosis (16.3 ± 7.6° vs. 10.9 ± 14.4°, p = 0.021) and T1-S1 spinal height (43.3 ± 6.7 mm vs. 39.1 ± 4.3 mm, p = 0.039) in the HD group. At final follow-up, only T1-S1 spinal height remained significantly higher in the HD group (45.4 ± 7 mm vs. 39.7 ± 5.1 mm, p = 0.021). Implant costs were significantly higher in the HD group (EUR 6046.5 ± 1146.9 vs. EUR 4376.4 ± 999.4, p < 0.001), while operative time, blood loss, and hospital stay length showed no significant differences. HD constructs had three major complications requiring surgical revision, whereas LD constructs reported no perioperative complications but experienced three late-onset complications also necessitating revision surgery. Conclusions: LD constructs provided comparable long-term radiographic and clinical outcomes to HD constructs, with significantly lower implant-related costs. Despite initial superior kyphosis correction in HD constructs, this benefit diminished by the final follow-up. These findings support a selective, lower-density screw placement strategy to minimize costs and surgical complexity without compromising patient outcomes in EOS undergoing definitive spinal fusion. Full article

Background: Reamer–irrigator–aspirators (RIAs) are newer orthopedic devices intended to harvest bone while minimizing complications associated with traditional harvesting techniques. Its high success rate has resulted in relatively few studies on its intraoperative and postoperative complications, especially in pediatric populations. This study provides a scoping review of complications associated with the RIA and presents an institutional case series of RIA complications. Materials and Methods: The scoping review was conducted via modified Joanna Briggs Institute (JBI) guidelines. Cases at a single institution were selected on an individual basis as they occurred during or after RIA-associated surgeries. Results: Our case series consists of three males and one female, ranging from 8 to 14 years old, with varying comorbid orthopedic conditions. All complications occurred intraoperatively, with three instances of retained hardware and one instance of cortical disruption. Each complication was classified as stage I according to the modified Clavien–Dindo–Sink classification system. There were no long-term sequelae despite limited management. A scoping review of the literature revealed extremely limited data on pediatric complications, but several mechanical and clinical complications have been described. Conclusions: Complications associated with RIA use in children appear to be inconsequential, but data are very sparse, and further studies are required. Full article

Background: The Profunda Artery Perforator (PAP) flap is a viable alternative to the Deep Inferior Epigastric Perforator (DIEP) flap, particularly for patients with low BMI and therefore insufficient abdominal tissue. To reduce the high complication rate, especially in our low BMI patient population, we have adapted the use of the vertical skin island design. This study compares complication rates and long-term outcomes of vertical versus horizontal skin island designs in PAP flap breast reconstruction. Methods: This prospective, single-center study included 20 patients who underwent PAP flap breast reconstruction. Quality of life and scar quality were assessed using the BREAST-Q and POSAS questionnaires. Additionally, the cosmetic outcomes were analyzed by four plastic surgeons. Results: Mean BMI in the vertical group was 23.9 kg/m² and 22.7 kg/m² in the horizontal group. Mean flap weight was 326 g for the vertical group and 355 g for the horizontal group. Fewer complications were observed at the donor site in the vertical group (Clavien–Dindo Classification 3b at donor site: p = 0.25). The BREAST-Q evaluation revealed significantly better results regarding the psycho-social well-being (p = 0.04) in patients with the horizontalskin island design. Scar evaluation using the POSAS revealed that the scar was perceived as thinner (p = 0.02), less pigmented (p = 0.03), and showed less relief (p = 0.02) in the vertical group. No significant difference was observed in the overall scar assessment by observers (p = 0.46). The aesthetic analysis by plastic surgeons showed significantly better results in the horizontal group. Conclusions: The vertical skin island design in PAP flap breast reconstruction was associated with lower complication rates and better scar quality compared to the horizontal design. Surgeons, however, rated the overall aesthetic outcome of the vertical design less favorably. These findings highlight the importance of balancing donor site morbidity with overall aesthetic results. Full article

Background/Objectives: The combination of different fungal extracts could be beneficial to cancer patients due to their role in gut microbiota modulation and anti-inflammatory activity. The study aimed to evaluate whether fungal extract supplementation reduces postsurgical complications in patients with colorectal cancer undergoing curative surgery. Methods: Patients were randomized to receive the nutraceutical Micodigest 2.0 or a placebo until surgery. Surgical complications were evaluated using the Clavien-Dindo classification. We also assessed the effect of the nutraceutical on gut microbiota composition, inflammatory response, nutritional status, and quality of life. A subanalysis based on surgery type (robotic vs. non-robotic) was performed. Results: We included 46 patients who met the inclusion criteria, with 27 randomized to the intervention group and 19 to the placebo group, receiving treatment for three (2–4) weeks. Non-robotic surgery was performed in 35 (76.1%) patients. We found non-significant differences in postoperative complications (Micodigest 2.0: 25.9%, placebo: 26.3%; p = 0.9). In non-robotic surgery, we identified a non-significant reduction in postoperative complications (Micodigest 2.0: 25.0%, placebo: 36.4%; p = 0.7), as well as a significant increase in lymphocyte levels and a reduction in the neutrophil-to-lymphocyte ratio (p = 0.02). Micodigest 2.0 supplementation was also associated with significant changes in gut microbiota composition, as indicated by a decreased relative abundance of the phyla Firmicutes (p = 0.004) and Actinobacteria (p = 0.04). Conclusions: Micodigest 2.0 supplementation was associated with non-significant reductions in postoperative complications and significant modifications in gut microbiota composition. Limitations: The trial did not reach the calculated sample size. Full article

Background: The standard treatment for maxillofacial abscesses is surgical drainage combined with antibiotics, a frequent procedure in maxillofacial surgery departments. However, postoperative complications following this surgery are poorly described in the literature. Identifying their incidence and risk factors could help improve patient outcomes and healthcare planning. Objectives: The primary aim was to identify postoperative complications within 30 days after maxillofacial abscess surgery; the secondary aim was to explore their associated risk factors. Methods: A monocentric retrospective cohort study included patients with maxillofacial abscesses who underwent extraoral incision and drainage under general anesthesia at the Department of Cranio-Maxillofacial and Oral Surgery at a tertiary hospital in Switzerland between January 2012 and August 2023. Postoperative complications within 30 days were recorded and classified according to the validated Dindo–Clavien classification system. Univariable and multivariable logistic regression analyses were conducted to identify risk factors for postoperative complications. Results: A total of 253 participants were analyzed. The overall complication rate was 24.1%, with 15.8% major complications (Dindo–Clavien grade ≥ 3). The most common minor complications (Dindo–Clavien grade < 3) were hypokalemia and lower-extremity edema, with an incidence of 6.4%. The most common major complications were persistent and recurrent abscesses, with an incidence rate of 10.4%. These complications occurred in the early (median range 1–5 days) and delayed (median range 14–15 days) postoperative courses, respectively. Overall, the mortality rate was 0.4%. On multivariable analysis, an American Society of Anesthesiologists (ASA) score > 2 was associated with overall and major postoperative complications (odds ratio [OR], 3.38; 95% CI 1.75–6.51; p < 0.001 and OR, 3.76; 95% CI 1.83–7.72; p < 0.001, respectively). Additionally, female sex (OR, 1.97; 95% CI 1.05–3.70; p = 0.036) and C-reactive protein level > 50 mg/L (OR, 2.25; 95% CI 1.01–4.98; p = 0.046) were associated with overall postoperative complications. Conclusions: This study introduces a novel application of the Dindo–Clavien classification to maxillofacial abscess surgery, providing a standardized framework for assessing postoperative complication severity. Through this approach, we identified ASA score > 2, female sex, and CRP level > 50 mg/L as risk factors for postoperative complications. Our findings highlight the importance of close monitoring during the first five postoperative days to detect early complications, such as persistent abscesses, and recommend standardized outpatient follow-up for at least two weeks to identify delayed complications, like recurrence. Full article

Background/Objectives: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the staging and treatment of testicular cancer and is often mandatory. RPLND is associated with a high risk of morbidity. The use of minimally invasive techniques has significantly increased the number of robotic procedures performed over the last few years. This study aimed to analyze the perioperative and postoperative outcomes and trends of an increasing number of surgeries performed. Materials and Methods: We retrospectively analyzed 30 robotic RPLNDs (R-RPLNDs) performed at our testicular cancer center between 2020 and 2024. Logistic regression analyses were used to analyze the independent variables of operative time (OT), hospital stay (HS), estimated blood loss, lymph node yield, and complications according to the Clavien–Dindo classification system. The independent predictors included case number, clinical stage, post-chemotherapy status, preoperative retroperitoneal tumor mass, and body mass index. Furthermore, the patients were categorized into three groups: group A (cases 1–10), group B (cases 11–20), and group C (cases 21–30). A Kruskal–Wallis test was performed to assess differences among the groups concerning OT, HS, and lymph node yield. Results: OT significantly decreased with an increasing number of cases (p < 0.001), and HS was significantly affected by overall complications (p = 0.0006). There were two major perioperative complications (6.6%). No factors predicted overall complications or Clavien–Dindo grades I-II or III–V. The Kruskal–Wallis test showed a significant difference (p < 0.05) in OT and HS for group C. Conclusions: R-RPLND for GCTs demonstrates a clear learning curve, with significant improvements in OT, HS, and complication rates as surgeons gain experience. Overall, the low complication rates for R-RPLND did not indicate predictive factors for perioperative or postoperative complications. RPLND presents promising potential as a safe and effective treatment for GCTs, especially when performed by experienced surgeons in specialized centers. Full article

Background/Purpose: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the surgical management of testicular cancer. However, RPLND is associated with a high risk of morbidity. Currently, open RPLND (O-RPLND) is considered the gold standard for surgical treatment. The use of minimally invasive techniques has increased significantly over the last few years. This study aimed to compare the safety and oncological outcomes of open (O-RPLND) and robotic (R-RPLND) retroperitoneal lymph node dissection for testicular cancer. Materials and Methods: We retrospectively analyzed all the patients who underwent RPLND at our testicular cancer center. Standard O-RPLND was performed with the usual equipment, and R-RPLND was performed with the Da Vinci X/Xi surgical system. The pre- and perioperative parameters and the postoperative complications (Clavien–Dindo classification), anejaculation, and the relapse rate were recorded. The association between the clinicopathological variables and the complications and relapse was assessed using regression analyses. Results: Sixty-five patients underwent RPLND during 2017–2024 due to testicular cancer (TC), with thirty-one (47.7%) receiving R-RPLND, including seventeen patients post-chemotherapy (55%). Meanwhile, 34 (52.3%) underwent O-RPLND, comprising 31 patients post-chemotherapy (91%). R-RPLND demonstrated excellent results compared to O-RPLND in terms of the operative time (OT) (p < 0.00001). The R-RPLND group had two (6.5%) high-grade (Clavien–Dindo III–V) complications, while four (11.8%) high-grade complications were noted in the O-RPLND group. R-RPLND was linked to a shorter OT (p < 0.00001). The hospital stay for R-RPLND was, on average, 2.7 days shorter. In logistic regression analysis, R-RPLND was non-inferior to O-RPLND for overall complications (p = 0.6) and low-grade Clavien–Dindo (I-II) (p = 0.2) and high-grade Clavien–Dindo (≥III) complications (p = 0.7). The median follow-up was 13 months for R-RPLND and 38 months for O-RPLND. Two relapses were observed in the R-RPLND group (6.5%), and two in the O-RPLND group (5.9%). One patient who underwent R-RPLND developed field-edge recurrence. No significant differences in the relapse and anejaculation rates were found between R-RPLND and O-RPLND (p = 0.9 and p = 0.8, respectively). Conclusions: In conclusion, R-RPLND is a feasible procedure with a low complication rate and an acceptable oncological outcome. It has proven to be significantly shorter to O-RPLND in relation to the lengths of HS and OT. However, R-RPLND is a demanding procedure with a considerable learning curve. Full article

Background and Objectives: In contrast to the standardization of laparoscopic gastrectomy techniques, the complexity of intracorporeal anastomosis techniques in totally laparoscopic total gastrectomy, the lack of standardization, the positional challenges posed by working in a confined space, and varying complication rates have prevented a consensus on the optimal intracorporeal digestive tract reconstruction method. Selecting an appropriate reconstruction method for esophagojejunostomy is crucial for a successful surgical outcome. This study aims to define a modified anastomotic technique for TLTG and share our experience with this technique. Materials and Methods: A total of 21 patients who underwent TLTG with D2 LND between July 2024 and December 2024 using the sutureless L-shape esophagojejunostomy (SLEJ) technique at the Surgical Oncology Clinic of Gulhane Training and Research Hospital due to gastric cancer were included in the study. In our technique, gastrectomy, lymph node dissection, anastomosis preparation, esophagojejunostomy anastomosis, and enteroenterostomy anastomosis were all performed laparoscopically and intracorporeally. Results: The mean operative time was 180.48 min, with a mean EJ anastomosis duration of 40.24 min. In the standard technique, two Endo GIA™ staplers were used for pyloric and small bowel transection, two for EJ anastomosis, and one for intracorporeal jejunojejunostomy. In only one patient, three staplers were used for anastomosis. Therefore, the average number of staplers was 5.05, with a mean of 2.05 staplers used for anastomosis. The mean hospital stay was 8.19 days, and there were no mortalities. The number of patients with an anastomotic leakage was 1. Since the patient’s general condition remained stable, percutaneous drainage or laparotomy was not planned. The patients’ esophagojejunostomy anastomotic leak was classified as Class 1 and Grade 3a according to the Clavien–Dindo classification. The average size of our widest incision was 3.28 cm, and surgical site infections were developed in two patients. Conclusions: Sutureless L-Shape With Endoscopic Assistance (SLEJ) is an easily applicable, technically simpler, shorter-in-duration, easier-to-learn, and safer intracorporeal EJ anastomosis technique with a low rate of postoperative complications. Full article

Background/Objectives: Advanced ovarian cancer (AOC) is frequently diagnosed at late stages, with a 5-year overall survival (OS) rate of approximately 25%. While primary debulking surgery followed by chemotherapy remains the standard treatment, neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) is an alternative for patients with extensive disease. Achieving complete cytoreduction is a critical prognostic factor for OS and progression-free survival (PFS). This study evaluated the prognostic value of two biomarkers—the neutrophil–lymphocyte ratio (NLR) and the cancer antigen-125 (CA-125) ELIMination rate constant K (KELIM)—in predicting survival outcomes and recurrence rates in patients with AOC undergoing NACT. Methods: A retrospective, single-center analysis was conducted on 78 patients with high-grade serous AOC (stages III–IV) treated with platinum-based NACT followed by IDS between January 2013 and December 2023. NLR was calculated from prechemotherapy complete blood counts, with a threshold of ≥3 indicating elevated levels. KELIM, a marker of tumor chemosensitivity, was derived from CA-125 kinetics during the first 100 days of chemotherapy, with a cutoff of ≥1 denoting a favorable outcome. Clinical outcomes, including PFS and OS were analyzed using Kaplan–Meier survival curves, log-rank tests, and Cox regression models. Results: Results demonstrated that elevated NLR (≥3) and low KELIM (<1) were associated with poorer PFS and OS. KELIM score was identified as a strong prognostic marker for both PFS and OS, while NLR demonstrated weak association. Complete cytoreduction was achieved in 69.2% of patients, significantly correlating with improved survival outcomes. Postoperative complications, assessed using the Clavien–Dindo classification, were observed in a small subset of patients, with a total median hospital stay of 8 days. Conclusions: This study highlights the potential of NLR and KELIM as prognostic tools in AOC, aiding in patient selection for radical surgical interventions and predicting chemosensitivity. Future multicenter studies with larger cohorts are needed to validate these results and further explore the clinical utility of these biomarkers in optimizing treatment strategies for AOC. Full article

Background and Objectives: Ovarian cancer surgery requires multiple radical resections with a high risk of complications. The aim of this single-centre, retrospective study was to determine the best method for predicting Clavien–Dindo grade ≥ III complications using machine learning techniques. Material and Methods: The study included 179 patients who underwent surgery at the gynaecological oncology department of Antalya Training and Research Hospital between January 2015 and December 2020. The data were randomly split into training set n = 134 (75%) and test set n = 45 (25%). We used 49 predictors to develop the best algorithm. Mean absolute error, root mean squared error, correlation coefficients, Mathew’s correlation coefficient, and F1 score were used to determine the best performing algorithm. Cohens’ kappa value was evaluated to analyse the consistency of the model with real data. The relationship between these predicted values and the actual values were then summarised using a confusion matrix. True positive (TP) rate, False positive (FP) rate, precision, recall, and Area under the curve (AUC) values were evaluated to demonstrate clinical usability and classification skills. Results: 139 patients (77.65%) had no morbidity or grade I-II CDC morbidity, while 40 patients (22.35%) had grade III or higher CDC morbidity. BayesNet was found to be the most effective prediction model. No dominant parameter was observed in the Bayesian net importance matrix plot. The true positive (TP) rate was 76%, false positive (FP) rate was 15.6%, recall rate (sensitivity) was 76.9%, and overall accuracy was 82.2% A receiver operating characteristic (ROC) analysis was performed to estimate CDC grade ≥ III. AUC was 0.863 with a statistical significance of p < 0.001, indicating a high degree of accuracy. Conclusions: The Bayesian network model achieved the highest accuracy compared to all other models in predicting CDC Grade ≥ III complications following epithelial ovarian cancer surgery. Full article

Objective: The incidence of urolithiasis in the paediatric population is rising, leading to a progressive shift towards minimally invasive management strategies. This study evaluated the efficacy and safety of using micro-ureteroscopy (micro-URS) to treat distal ureteral stones in preschool-aged paediatric patients. Methods: A retrospective analysis was conducted on 57 children (aged 6–72 months), all of whom had undergone micro-URS treatment for distal ureteral stones between September 2022 and April 2024. Patient demographics, along with perioperative and postoperative outcomes, were assessed. Stone fragmentation was achieved using a 4.85 Fr micro-ureteroscope and a 200 μm Ho:YAG laser fibre. Postoperative complications were graded according to the Clavien–Dindo classification system, and stone-free status was confirmed for each patient at their one-month follow-up appointment. Results: The mean patient age was 44.2 months, and the median stone size was 9.4 mm (range: 6–24 mm). Stone-free status was confirmed in all patients at their one-month follow-up appointment. In 22.8% of cases, reintervention was required to address minor complications, including haematuria (n = 6), urinary tract infections (n = 4), and stone migration (n = 3). No major intraoperative complications were observed. A total of 41 patients (71.9%) required a double-J stent to treat intraoperative oedema or stone impaction. The mean operative time was 28.6 min, and the mean hospitalisation duration was 19.7 h. Conclusions: Micro-URS achieved a 100% stone-free rate with minimal complications, establishing it as a safe and highly effective option for treating distal ureteral stones in preschool-aged children. These findings show that micro-URS offers advantages over Shock Wave Lithotripsy (SWL) in paediatric urolithiasis management, supporting it as a first-line treatment modality. Further prospective, randomised studies are needed to validate these results. Full article

Background: Thoracic schwannomas are benign nerve sheath tumors that can cause neurological and respiratory symptoms depending on their location and extension. The optimal surgical approach remains debated, particularly regarding resection extent, complication rates, and postoperative morbidity. Methods: This retrospective multicenter study analyzed 106 patients treated between 2011 and 2024, classifying tumors according to the Eden system and comparing surgical strategies. Surgical variables, including operative time, blood loss, resection extent, recurrence rates, and complications classified by Clavien–Dindo, were analyzed. Results: Eden I and II schwannomas were treated with laminectomy (LCT) or hemilaminectomy (HLCT) and transpedicular approaches (TPD), achieving high gross total resection (GTR) rates with minimal complications. Eden III dumbbell tumors benefited from a combined neurosurgical–thoracic approach (LCT + VATS), which resulted in higher GTR rates (100% vs. 62%, p < 0.01) and lower dural complications compared to neurosurgical resection alone. Eden IV extraforaminal schwannomas were best managed with VATS, which was associated with lower intraoperative blood loss (p = 0.018), shorter surgical duration (p = 0.027), and reduced postoperative complications compared to open thoracotomy. Our findings confirm that minimally invasive techniques, particularly VATS and combined neurosurgical–thoracic approaches, optimize tumor resection while reducing morbidity. However, feasibility depends on institutional resources and multidisciplinary collaboration. Conclusions: This study provides a stratified comparison of surgical approaches tailored to Eden classification, aiming to identify the most effective and least morbid strategies for each lesion type. Future prospective studies should validate these findings, integrating preoperative functional assessments and long-term follow-up to better stratify surgical risk, personalize operative planning, and refine surgical decision making for thoracic schwannomas. Full article

Background/Objectives: The aim of the study was to compare the perioperative and oncologic outcomes of patients who underwent surgery for colorectal cancer (CRC) performed using laparoscopy or using the Medtronic Hugo™ Robotic-Assisted Surgery (RAS) system. Methods: This is a retrospective comparative single-center study of consecutive minimally invasive surgeries for CRC performed by two colorectal surgeons with extensive laparoscopic experience at the beginning of their robotic expertise. Patients were not selected for the surgical approach, but waiting lists and operating room availability determined whether the patients were in the robotic group or the laparoscopic group. The primary outcome was to compare 30-day postoperative complications according to the Clavien–Dindo classification and the Complication Comprehensive Index (CCI). The secondary outcomes included operating times, conversion rates, intraoperative complications, length of hospital stays (LOS), readmission rates, and short-term oncologic outcomes, such as the R0 resection, the number of lymph nodes harvested, the total mesorectal excision (TME) quality, and the circumferential resection margin (CRM). Results: Of the 109 patients, 52 underwent robotic and 57 laparoscopic CRC surgery. Patient demographic and clinical characteristics were similar in the two groups. There was no significant difference between the robotic and the laparoscopic groups regarding postoperative complications, the Clavien–Dindo classification, and the CCI. They also had similar operating times, conversion rates, intraoperative complications, LOSs, readmission rates, and short-term oncologic outcomes (the lymph nodes harvested, the R0 resection, TME quality, and CRM status). Conclusions: This study reports the largest cohort of CRC surgery performed using the Medtronic Hugo™ RAS system and is the first comparative study with laparoscopy. The perioperative and oncologic outcomes were similar, demonstrating that the Medtronic Hugo™ RAS system is safe and feasible for CRC as compared to laparoscopic surgery, even at the beginning of the robotic experience. Full article