Robot-Assisted vs Laparoscopic Right Hemicolectomy in Octogenarians.

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.