Colorectal Surgery, Queen Alexandra Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK.
Department of General and Oncological Surgery - Surgery C, Sheba Medical Center, Ramat Gan, Israel.
Int J Med Robot. 2021 Aug;17(4):e2268. doi: 10.1002/rcs.2268. Epub 2021 May 21.
We evaluated the short-term outcomes of robotic colorectal cancer surgery in octogenarian patients, focussing on postoperative morbidity and survival.
All patients ≥80 years in a prospective colorectal cancer database undergoing robotic curative colorectal cancer resection were included. Patient demographics, intraoperative findings, postoperative and oncological outcomes were recorded. Patients were further subdivided into two groups named: old (OG 80-85 years) and very old (VOG ≥ 86 years).
Fifty-eight consecutive patients were included (median age, 83 years; male, 53.4%; median BMI, 26.5). Median total operative time was 230 min, median blood loss 20 ml, median length of stay 7 days. Major complications were seen in 12% of patients; and the 90-day mortality rate was 1.7%. Complete R0 resection achieved in 93% of cases, average lymph node harvest was 22. Overall and disease-free survival was 81% and 87.3%, respectively (median follow-up 24.5 months). We noticed a trend towards more advanced lesion staging in the VOG, but only N2 stage was significant (p = 0.03). There was a statistically significant difference in overall survival in favour of the OG (p = 0.024).
Robotic surgery is feasible in octogenarian patients undergoing curative colorectal cancer resection and is associated with good post-operative outcomes and overall survival.
我们评估了 80 岁以上机器人结直肠癌手术的短期结果，重点关注术后发病率和生存率。
所有在接受机器人结直肠肿瘤切除术的前瞻性结直肠癌数据库中年龄≥80 岁的患者均被纳入。记录患者的人口统计学资料、术中发现、术后和肿瘤学结果。患者进一步分为两组：老年组（OG 80-85 岁）和非常老年组（VOG ≥ 86 岁）。
连续纳入 58 例患者（中位年龄 83 岁；男性 53.4%；中位 BMI 26.5）。中位总手术时间为 230 分钟，中位出血量 20 毫升，中位住院时间 7 天。12%的患者出现严重并发症；90 天死亡率为 1.7%。93%的病例达到了完全 R0 切除，平均淋巴结清扫 22 个。总体生存率和无病生存率分别为 81%和 87.3%（中位随访 24.5 个月）。我们注意到 VOG 中晚期病变分期的趋势，但只有 N2 期有显著差异（p=0.03）。OG 的总体生存率有统计学意义（p=0.024）。
机器人手术在接受根治性结直肠癌切除术的 80 岁以上患者中是可行的，并且与良好的术后结果和总体生存率相关。
