Faster postoperative recovery by robotic-assisted surgery in elderly patients with sigmoid colon and rectal cancer

Pingping Xu , Yang Lv , Zhengchuan Niu , Qi Lin , Dexiang Zhu , Ye Wei , Jianmin Xu
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Abstract

Background

Currently, no published studies have compared the short-term and long-term outcomes of robotic-assisted and open surgery for elderly patients (aged 65 years or older) with sigmoid colon and rectal cancer in China. Hence, our study was conducted to assess whether robotic-assisted surgery is superior to traditional approaches.

Methods

A total of 208 patients who received either open resection (n ​= ​93) or robotic-assisted resection (n ​= ​115) between October 2010 and October 2014 were included in the study. We compared clinical characteristic variables and patient demographics between the two approaches and assessed short- and long-term outcomes.

Results

Patient characteristics were not significantly different between the groups. First flatus postoperative days (P ​< .001), less time to liquid diet (P ​= ​.004), and shorter postoperative hospital stay (P ​= ​.046) were found in the robotic-assisted surgery group. The operation time was also more in the robotic-assisted surgery group (P ​= ​.03). The 3-year overall survival rate was 83.0% in the robotic-assisted surgery group and 78.0% in the open surgery group (P ​= ​.938). The 3-year disease free survival rate was 76.0% and 72.0% in the robotic-assisted surgery and open surgery groups, respectively (P ​= ​.817). No significant difference was found in the overall survival and disease-free survival between the two approaches.

Conclusions

Robotic-assisted surgery is safe and feasible for elderly patients with sigmoid colon and rectal cancer and is associated with more operation time and faster recovery as compared to open surgery. No significant differences were found in 3-year survival outcomes between the two groups.

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机器人辅助手术治疗老年乙状结肠直肠癌患者术后更快恢复
目前,在中国还没有发表的研究比较机器人辅助手术和开放手术治疗老年(65岁及以上)乙状结肠直肠癌患者的短期和长期结果。因此,我们的研究是为了评估机器人辅助手术是否优于传统方法。方法选取2010年10月至2014年10月期间接受开放切除(n = 93)或机器人辅助切除(n = 115)的208例患者作为研究对象。我们比较了两种方法的临床特征变量和患者人口统计数据,并评估了短期和长期结果。结果两组患者特征无显著差异。术后第一次放屁天数(P <.001),液体饮食时间更短(P = 0.004),术后住院时间更短(P = 0.046)。机器人辅助手术组的手术时间也更长(P = .03)。机器人辅助手术组3年总生存率为83.0%,开放手术组3年总生存率为78.0% (P = 0.938)。机器人辅助手术组和开放手术组3年无病生存率分别为76.0%和72.0% (P = .817)。两种方法的总生存期和无病生存期无显著差异。结论机器人辅助手术治疗老年乙状结肠直肠癌安全可行,手术时间短,恢复快。两组患者的3年生存率无显著差异。
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