Robotic-assisted surgery is increasingly being utilized for colorectal surgery. Data are scarce and contradictory when outcomes are compared between robotic and laparoscopic surgery. All patients undergoing minimally invasive colorectal surgery were compared from 2011 to 2016. Outcomes between the two groups were statistically analyzed. p < 0.05 was considered statistically significant. 185 patients underwent laparoscopic resection and 70 underwent robotic resection. Demographics, ASA score, and BMI were similar between the two groups (p > 0.05). There was no statistical difference in median length of stay between laparoscopic and robotic colon (both 4 days; p = 0.5) and rectal (6 vs 4.5 days; p = 0.2) resections. Median operative times were also similar between the two approaches for colon (150.5 vs 169.5 min, p = 0.2) and rectal (197.0 vs 231.5 min, p = 0.9) resections. There was also no difference in operative time between the two approaches for right (median = 137 vs 130.5 min; p = 0.9) and left (median = 162.0 vs 170.5 min; p = 0.6) colectomies. Robotic surgery results in similar operative times and length of stay as laparoscopic surgery for patients undergoing colon and rectal resections.
Colorectal cancer continues to be the third most common cause of cancer death in the United States. Access to health care is also a nationwide problem. The purpose of the current study is to see if insurance status is associated with stage of colon cancer at presentation. The tumor registry was queried for all patients with colon cancer from 2009 to 2014. Demographics, including insurance status was statistically analyzed to determine if an association existed between insurance status and stage of colon cancer at the time of presentation. There were 434 patients identified that underwent colonic resection during the study period; 224 were female and 210 were male. Of the 434 patients, 388 were insured and 46 were uninsured. When insurance status was compared with stage at diagnosis there was a statistically significant difference between the two groups. For patients that were uninsured, 13.01 per cent presented with stage I disease, 15.22 per cent with stage II disease, 34.78 per cent with stage III disease, and 36.96 with stage IV disease. For insured patients, 24.03 per cent present with stage I disease, 26.10 with stage II disease, 23.26 per cent with stage III disease, and 29.61 per cent with stage IV disease (P = 0.047). Access to health care continues to be a large problem and results in patients without insurance presenting with a high stage of disease.
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