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Rise in Minimally Invasive Surgery for Colorectal Cancer Is Associated With Adoption of Robotic Surgery
Naveen Manisundaram1,2, Christopher P Childers3, Chung-Yuan Hu1
1Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Diseases of the Colon and Rectum
|January 2, 2025
Summary
Minimally invasive surgery (MIS) for colorectal cancer increased from 2010-2020, driven by robotic surgery adoption. While laparoscopic rates plateaued, open surgery declined, indicating a shift toward advanced MIS techniques.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery Trends
- Colorectal Cancer Treatment
Background:
- Minimally invasive surgery (MIS) offers improved short-term outcomes and comparable long-term oncologic results for colorectal cancer patients versus open surgery.
- The impact of robotic surgery on the overall utilization of traditional laparoscopic and minimally invasive approaches for colorectal cancer remains unclear.
Purpose of the Study:
- To delineate trends in open, robotic, and laparoscopic surgical approaches for colorectal cancer resections.
- To identify factors associated with the increasing adoption of minimally invasive surgery in colorectal cancer treatment.
Main Methods:
- Retrospective cohort study analyzing data from the National Cancer Database (2010-2020).
- Inclusion criteria: Patients diagnosed with nonmetastatic colon or rectal adenocarcinoma.
- Outcome measures: Rates of open, robotic, and laparoscopic surgical approaches.
Main Results:
- Analysis of 475,001 patients revealed shifts in surgical approach: open (40.5%), robotic (13.7%), and laparoscopic (45.9%).
- For colon cancer, laparoscopic MIS use peaked in 2016 (54.0%), with total MIS exceeding open surgery from 2013-2020.
- For rectal cancer, laparoscopic MIS peaked in 2014 (37.2%) and declined, while robotic surgery prevalence surged to 48.8% by 2020. Open surgery declined across both cancer types.
Conclusions:
- Minimally invasive surgery utilization steadily increased from 2010-2020, with open resections declining and robotic resections rising for both colon and rectal cancers.
- The overall rise in MIS for colorectal cancer appears significantly influenced by the increasing adoption of robot-assisted surgery.
- Study limitations include reliance on the National Cancer Database, potentially limiting generalizability to non-Commission on Cancer-accredited institutions.
