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

Author(s): Mazin Hamed, Melanie Holzgang, Yining Chen, Wanda Ward, Dolly Dowsett, Irshad Shaikh, Ahmed El-Hadi

Introduction: Colorectal cancer is becoming an increasingly common health issue, especially among the elderly population. We aimed to assess the shortterm postoperative outcomes of robotic colorectal cancer surgery in elderly (≥ 75 years) and non-elderly (<75 years) patient groups.

Materials and Methods: Patients who underwent robotic colorectal cancer resections in our tertiary colorectal referral center between October 2017 and May 2022 with the Da Vinci X system were included in this retrospective study. Patients were divided into two groups: the “elderly group” including patients ≥75 years, and the “non-elderly” group including patients <75 years. The short-term postoperative outcomes between these two groups were then compared using the Chi-squared/Fisher’s exact or Wilcoxon test. Differences were considered statistically significant at P< 0.05.

Results: A total of 228 patients were included in our study; 61 patients ≥ 75 years old (elderly group) and 167 patients < 75 years old (non-elderly group).

Although there were no statistically significant differences observed between the elderly and non-elderly patient groups regarding length of hospital stay, anastomotic leak, re-admission and re-operation rates, the elderly group had a significantly shorter operative time (mean time 275.35 minutes vs. 315.14 minutes; p < 0.001) compared to the non-elderly group. The results for left and right robotic colonic cancer resections were analyzed separately and there were no statistical differences observed in any of the outcomes that were included in our study.

Conclusion: Our study results on robotic colorectal cancer surgery in elderly patients suggest that it is a safe and feasible surgical approach. The operative times and short-term postoperative outcomes of elderly patients were comparable to those of the non-elderly group. This indicates that robotic colorectal cancer surgery is a viable option for elderly patients.

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