Influence of robotics in surgical complication rate in elderly population with rectal cancer
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ORIGINAL ARTICLE
Influence of robotics in surgical complication rate in elderly population with rectal cancer Irene Ramallo‑Solis1 · Rosa M. Jimenez‑Rodriguez1,6 · M. Luisa Reyes‑Diaz1 · José Manuel Diaz‑Pavon1 · Jorge Manuel Vazquez‑Monchul2 · Ana M. Garcia‑Cabrera1 · Javier Padillo3,5 · Fernando de la Portilla4,5 Received: 30 May 2019 / Accepted: 17 August 2019 © Springer Nature Switzerland AG 2019
Abstract Background Rectal cancer surgery is a technically complex procedure. Moreover, short-term outcomes show high rate of complications especially in elderly and laparoscopic surgery has not demonstrated to be able to reduce this complication rate. Robotics has several advantages in pelvic surgical procedures, which could have an impact in complication rates in elderly patients. Aims The aim of our study is to demonstrate whether robotic surgery has any influence on the reduction of complications in the aged population undergoing rectal cancer. Methods We performed a retrospective analysis of a prospective database of 151 patients who underwent robotic surgery for rectal cancer. We divided our population into three groups: under 65-year-old, between 65- and 80-year-old and above 80-year-old. We recorded complications in each group intra and post procedure. Results The present study included 151 patients (94 males). Of them, 77 patients were under 66 year old, 63 patients were between 66 and 79 year old and 11 patients were 80 year old and above. The analysis showed conversion rates of 10.38%, 13.69%, 27.27%, and the complication rate of 23.4%, 23.8%, and 27.3% in each group. Univariate analysis showed no differences between the three groups. Nevertheless, there were statistical differences from BMI, ASA and neoadjuvant therapy. In multivariant analysis only neoadjuvant therapy was significant. Conclusions Robotic approach does not decrease complications in elderly population and conversion is similar in these age groups. So we should not rule out robotic surgery in elderly patients, although we must select each case with a multidisciplinary approach. Keywords Rectal cancer · Rectal surgery · Robotics · Elderly · Complications
Introduction Laparoscopic surgery has recently been accepted for the treatment of rectal cancer [1], however, short and long-term results in elderly patients remain controversial. Elderly * Rosa M. Jimenez‑Rodriguez [email protected] 1
Department of General and Digestive Surgery, Colorectal Surgery Unit, “Virgen del Rocío” University Hospital, Seville 41013, Spain
2
Department of General and Digestive Surgery, Colorrectal Surgery Unit, “Virgen del Rocío”, Seville 41013, Spain
3
Department of General and Digestive Surgery, “Virgen del Rocío” University Hospital/IBiS/CSIC/University of Seville, Seville 41013, Spain
population frequently present comorbidities and are usually “frail”, so they often present a higher risk of morbidity and mortality. Recently, some authors such as Ishibe et al. [2] and Manceau et al. [3] have shown cosmetic benefits with equal oncological resul
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