Abstract
Purpose
While robotic surgery is more costly and involves longer intra-operative time, it has a technical advantage over laparoscopic surgery. With our aging population, patients are being diagnosed with colon cancer at older ages. The aim of this study is to compare laparoscopic versus robotic colectomy short- and long-term outcomes in elderly patients diagnosed with colon cancer at a national level.
Methods
This retrospective cohort study was conducted using the National Cancer Database. Subjects ≥ 80-years-old who were diagnosed with stage I to III colon adenocarcinoma and underwent a robotic or laparoscopic colectomy from 2010–2018 were included. The laparoscopic group was propensity-score matched in a 3:1 ratio to the robotic group with 9343 laparoscopic and 3116 robotic cases matched. The main outcomes evaluated were 30-day mortality, 30-day readmission rate, median survival, and length of stay.
Results
There was no significant difference in the 30-day readmission rate (OR = 1.1, CI = 0.94–1.29, p = 0.23) or 30-day mortality rate (OR = 1.05, CI = 0.86–1.28, p = 0.63) between both groups. Robotic surgery was associated with higher overall survival (42 vs 44.7 months, p < 0.001) using a Kaplan-Meier survival curve. Robotic surgery had a statistically significant shorter length of stay (6.4 vs. 5.9 days, p < 0.001).
Conclusion
Robotic colectomies are associated with higher median survival rates and decrease in the length of hospital stay compared to laparoscopic colectomies in the elderly population.
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Data availability statement
The primary database is available publicly through the American College of Surgeons (https://www.facs.org/quality-programs/cancer/ncdb). The data analyzed in this study is available from the corresponding author upon reasonable request.
Change history
23 December 2023
A Correction to this paper has been published: https://doi.org/10.1007/s00384-023-04582-8
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Acknowledgements
We acknowledge Eduardo Serpa who contributed with the ideation of the concept in this article.
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Data acquisition: Pacheco, Harris-Gendron. Statistical analysis: Pacheco, Zreik, Kamel. Drafting of Manuscript: Pacheco, Harris-Gendron, Luciano, Zreik. Critical revision of manuscript: Pacheco, Harris-Gendron, Luciano, Solh, Kamel.
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Pacheco, F., Harris-Gendron, S., Luciano, E. et al. Robotic versus laparoscopic colectomy outcomes in colon adenocarcinoma in the elderly population: a propensity-score matched analysis of the National Cancer Database. Int J Colorectal Dis 38, 183 (2023). https://doi.org/10.1007/s00384-023-04481-y
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DOI: https://doi.org/10.1007/s00384-023-04481-y