Robotic colorectal cancer surgery in the elderly – a monocentric analysis of short- term postoperative outcomes in patients ≥ 75 years versus <75 years

Author:

Holzgang Melanie1,Hamed Mazin1,Chen Yining2,Famurewa Jolaa1,Ward Wanda1,Dowsett Dolly1,Shaikh Irshad1,El-Hadi Ahmed1

Affiliation:

1. Norfolk and Norwich University Hospitals NHS Foundation Trust

2. London School of Economics and Political Science

Abstract

Abstract Introduction Colorectal cancer is increasingly prevalent in the elderly. We aimed to investigate the short-term postoperative outcomes in robotic colorectal cancer surgery in an elderly (≥ 75 years) versus a non-elderly (< 75 years) patient group. Materials and Methods 228 patients (61 patients > 75yrs vs. 167 < 75yrs) with confirmed colorectal cancer, operated between 10/17 and 05/22 with the Da Vinci X system, were identified. Short-term postoperative outcomes were compared using the Chi-squared/Fisher’s exact or Wilcoxon test. P < 0.05 was considered statistically significant. Results No statistical differences were observed in any of the outcomes looked at between our two patient groups, nor overall, nor analyzing left- or right-sided resections separately. Looking at left resections, operative time was shorter in the elderly group (314.66 min vs. 327.76 min, p = 0.347) whereas length of stay was over a day longer (7.72 vs. 6.08, p = 0.054), however, the differences observed did not reach statistical significance. Anastomotic leak, re-admission and re-operation rates in left resections were all higher in the non-elderly group (11% vs. 0%, p = 0.075; 8.1% vs. 3.4%, p = 0.694; 3.7% vs. 0%, p = 0.588), however, all not statistically significant. Looking at right resections, operative time was non significantly shorter in the elderly group (239.13 min vs. 259.81, p = 0.363), whereas length of stay was nearly identical (5.63 days vs. 5.52 days, p = 0.867). Conclusion Our Study results suggest that robotic colorectal cancer surgery is safe and feasible in elderly patients. Elderly patients demonstrated comparable outcomes to the non-elderly group in terms of operative times and short-term postoperative outcomes.

Publisher

Research Square Platform LLC

Reference17 articles.

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4. Hashida H et al, Laparoscopic Surgery for Colorectal Cancer in Super-Elderly patients: A single-center analysis, Surg Laparosc Endosc Percutan Tech 2020 Nov 23;31(3):337–341 doi: 10.1097/SLE.0000000000000876

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