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Robot-Assisted vs Laparoscopic Right Hemicolectomy in Octogenarians.

Havish Srinath1, Tae-Jun Kim2, Isabella J Mor1

  • 1Department of Colorectal Surgery, The Tweed Hospital, Tweed Heads, New South Wales, Australia; Department of Colorectal Surgery, John Flynn Private Hospital, Tugun, Queensland, Australia.

Journal of the American Medical Directors Association
|March 5, 2022
PubMed
Summary

Robotic right hemicolectomy (RRH) is a safe alternative to laparoscopic right hemicolectomy (LRH) for octogenarians, showing similar complication rates. RRH offers a shorter hospital stay and fewer minor complications in older adults undergoing colon surgery.

Keywords:
Roboticelderlyhemicolectomylaparoscopicoctogenarianresection

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Area of Science:

  • Colorectal Surgery
  • Minimally Invasive Surgery
  • Geriatric Surgery

Background:

  • Older adults (>80 years) have increased need for right-sided colonic resections.
  • Advanced age is linked to higher operative risks due to diminished physical status.
  • Robotic surgery's role in elderly patients compared to laparoscopy warrants investigation.

Purpose of the Study:

  • To compare the safety and effectiveness of robotic right hemicolectomy (RRH) versus laparoscopic right hemicolectomy (LRH) in octogenarians.
  • To evaluate complication rates, operative outcomes, and length of stay between RRH and LRH in elderly patients.

Main Methods:

  • Retrospective cross-sectional analysis of octogenarians undergoing elective RRH or LRH.
  • Comparison of 30-day complications, operative time, length of stay, and oncologic outcomes.
  • Univariate and multivariate analyses were used to compare patient groups.

Main Results:

  • Seventy-eight patients were analyzed; groups had similar demographics and comorbidities.
  • Robotic right hemicolectomy (RRH) showed a significantly shorter length of stay (5 vs. 8 days) and fewer minor complications (24.5% vs. 34.5%).
  • Major and overall complication rates were similar; oncologic outcomes were comparable between RRH and LRH.

Conclusions:

  • Robotic right hemicolectomy (RRH) is a safe and viable alternative to laparoscopic right hemicolectomy (LRH) for octogenarians.
  • RRH may offer advantages in reduced length of stay and minor complication rates for elderly patients.
  • Future research should explore intracorporeal anastomoses in robotic surgery for potential benefits in inpatient length of stay.