Benefits of minimally invasive surgery for rectal cancer in older adults compared with younger adults: a retrospective study

J Robot Surg. 2023 Aug;17(4):1825-1833. doi: 10.1007/s11701-023-01602-1. Epub 2023 Apr 21.

Abstract

Randomized research demonstrated that robotic surgery was oncologically safe and beneficial in the short term. We investigated whether older adults benefit from robotics more than younger adults do in terms of short-term outcomes. We identified all older (≥ 70 years old) and younger (≤ 70) adults with rectal cancer treated with resection between 2019 and 2022 from an institutional database. We assessed the short-term post-operative 90-day outcomes, which included the first bowel movement, length of hospital duration, sepsis, and harvested lymph node on an age-based differentiation. The key outcomes were complications and grades III-IV on the Clavien-Dindo scale. We identified 298 individuals treated with oncologic resection of rectal cancer: 108 (36.6%) were older adults, while 190 (63.4%) were younger adults. Older adults treated with robotic surgery include 45 (41.6%), whereas 63 (58.3%) older adults were treated with laparoscopic surgery, and 85 (44.7%) younger adults were treated with robotic surgery, while 105 (55.2%) younger adults were treated with laparoscopic surgery. The Clavien-Dindo grading system exposes a substantial P < 0.05 in younger group, whereas grade III-IV patients are seen more frequently in laparoscopic surgery than robotic surgery. Younger and older persons both benefited differently from robotic surgery when compared to laparoscopic surgery in terms of major post-operative complications.

Keywords: Colorectal surgery; Complications; Laparoscopic; Older versus younger; Robotic.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Humans
  • Laparoscopy* / adverse effects
  • Postoperative Complications / etiology
  • Rectal Neoplasms* / pathology
  • Rectal Neoplasms* / surgery
  • Retrospective Studies
  • Robotic Surgical Procedures* / methods
  • Treatment Outcome