Robot-assisted colorectal operations compared to the laparoscopic approach
DOI:
https://doi.org/10.55791/tkafg851Keywords:
robotic surgery, colorectal cancer, oncological outcomes.Abstract
Background: The minimally invasive approach has become increasingly interesting in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics used in colorectal cancer in terms of oncologic and clinical outcomes in a small general hospital.
Methods: We analyzed and compared two group of patients operated robotically and laparoscopically. 85 patients operated robotically (49% female, 51% male). The average age was 63.5 years, 110 patients operated laparoscopic operations (64% male, 36% female), the average age was 65.5 years.
Results: In all patients radical resection was performed. The average number of isolated lymph nodes in the robotic method was 19, while in laparoscopic method there were 155. The hospitalization was shorter in the robotic surgery patients (average 7.3 days), on the other hand the duration of the robotic operations was longer than the laparoscopic operations. Intraoperative blood loss was smaller in the robotic method (50-120 ml) in comparison with laparoscopic method (100-300 ml). Conversion to open surgery was lower when using the robotic method (4,5%) than in laparoscopic method( 7%). Laparoscopic method has more frequent complications 9 (10,3%) while robotic method 4 (9%). In 10 years follow up 9 laparoscopically operated died (10,3%), (5 due to cardiovascular disease, 4 due to progression of disease). In this period, 3 robotically operated patients died (6%), one due to progression of the disease, the others due to cardiovascular disease. The most common operation was right hemicolectomy (46%) by laparoscopic procedure, and using the robotic method it was anterior resection of the rectum (54%).
Conclusion: RCS is a promising technique and is a safe and effective alternative to LCS for colorectal surgery. The advantages of RCS include reduced EBLs, lower conversion rates and shorter times to recovery of bowel function. Further studies are required to define the financial effects of RCS and the effects of RCS on long-term oncological outcomes.
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