Minimally invasive surgery improves survival after colorectal cancer resection

Tanis, Pieter J.

doi:10.1111/codi.15906

Cited by 3 publications

(6 citation statements)

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“…Laparoscopic surgery was one of the earliest types of MIS that could be performed through one or more small incisions. 6 Laparoscopic radical resection of colorectal tumors is thought to provide high-quality colorectal resection with minimal surgical damage to surrounding tissues and organs. Robotic surgery is another MIS that provides a magnified three-dimensional view of the surgical site and helps surgeons perform precise, flexible, and controlled manipulations.…”

Section: Introductionmentioning

confidence: 99%

“…7,8 Given these options, many researchers have shifted their interests to comparing postoperative and oncological outcomes of CRC patients between robotic and conventional laparoscopic surgery. 6,9 The prevalence of obesity and the burden of obesity-related diseases have been increasing globally over the last several decades. 10 Obesity is associated with various metabolic diseases, including diabetes, non-alcoholic fatty liver disease, cardiovascular disease, hypertension, and obstructive sleep apnea syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…MIS is associated with less pain, shorter hospital stays, and fewer complications, allowing surgeons to use a variety of techniques to perform MIS with less damage to the body than open surgery. Laparoscopic surgery was one of the earliest types of MIS that could be performed through one or more small incisions 6 . Laparoscopic radical resection of colorectal tumors is thought to provide high‐quality colorectal resection with minimal surgical damage to surrounding tissues and organs.…”

Section: Introductionmentioning

confidence: 99%

“…Robotic surgery is another MIS that provides a magnified three‐dimensional view of the surgical site and helps surgeons perform precise, flexible, and controlled manipulations 7,8 . Given these options, many researchers have shifted their interests to comparing postoperative and oncological outcomes of CRC patients between robotic and conventional laparoscopic surgery 6,9 …”

Section: Introductionmentioning

confidence: 99%

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Outcomes of robot‐assisted versus laparoscopic surgery for colorectal cancer in morbidly obese patients: A propensity score‐matched analysis of the US Nationwide Inpatient Sample

Juang

Chung

Cheng

et al. 2023

J of Gastro and Hepatol

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Background and AimMorbid obesity is associated with poorer postoperative outcomes in colorectal cancer (CRC) patients. We aimed to evaluate short‐term outcomes after robotic versus conventional laparoscopic CRC resection in morbidly obese patients.MethodsThis population‐based, retrospective study extracted data from the US Nationwide Inpatient Sample during 2005–2018. Adults ≥ 20 years old, with morbid obesity and CRC, and undergoing robotic or laparoscopic resections were identified. Propensity score matching (PSM) was applied to minimize the confounding. Univariate and multivariable regression was conducted to evaluate the associations between outcomes and study variables.ResultsAfter PSM, 1296 patients remained. The risks of any postoperative complication (adjusted odds ratio [aOR] = 0.99, 95% confidence interval [CI]: 0.80, 1.22), prolonged length of stay (LOS) (aOR = 0.80, 95% CI: 0.63, 1.01), death (aOR = 0.57, 95% CI: 0.11, 3.10), or pneumonia (aOR = 1.13, 95% CI: 0.73, 1.77) were not significantly different between the two procedures after adjustment. Robotic surgery was significantly associated with greater hospital cost (aBeta = 26.26, 95% CI: 16.08, 36.45) than laparoscopic surgery. Stratified analyses revealed that, in patients with tumor located at the colon, robotic surgery was associated with lower risk of prolonged LOS (aOR = 0.72, 95% CI: 0.54, 0.95).ConclusionsIn patients with morbid obesity, risks of postoperative complication, death, or pneumonia are not significantly different between robotic and laparoscopic CRC resection. Among patients with tumor located at the colon, robotic surgery is associated with lower risk of prolonged LOS. These findings fill the knowledge gap and provide useful information for clinicians on risk stratification and treatment choice.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Outcomes of robot‐assisted versus laparoscopic surgery for colorectal cancer in morbidly obese patients: A propensity score‐matched analysis of the US Nationwide Inpatient Sample

Juang

Chung

Cheng

et al. 2023

J of Gastro and Hepatol

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“…6 Laparoscopic surgery is one of the earliest types of MIS and can be performed through small incisions. 7 In recent years, technological developments have led to laparoscopic-assisted radical resection of CRC, and the procedure has gradually become popular. This surgical approach can reduce trauma and surgery-related complications, improve postoperative functional recovery, and has been demonstrated to be an effective and safe treatment for CRC.…”

mentioning

confidence: 99%

Outcomes of Robot-Assisted Versus Laparoscopic Surgery for Colorectal Cancer in Adults ≥ 75 Years Old: A Propensity Score Matched Analysis of the US Nationwide Inpatient Sample

Chung,

Wu,

et al. 2024

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Robot-assisted surgery has been increasingly adopted in colorectal cancer resection. OBJECTIVE: The study aimed to compare the inpatient outcomes of robot-assisted versus conventional laparoscopic colorectal cancer resection in patients ≥ 75 years. DESIGN: A retrospective, population-based study. SETTINGS: This study analyzed data from the United States Nationwide Inpatient Sample from 2005 to 2018. PATIENTS: Colorectal cancer patients ≥ 75 years old and underwent robot-assisted or conventional laparoscopic resection. MAIN OUTCOME MEASURES: Postoperative complication, prolonged length of stay, and total hospital costs were assessed. RESULTS: Data from 14,108 patients were analyzed. After adjustment, any postoperative complications (aOR = 0.87, 95% CI: 0.77-0.99, p = 0.030) and prolonged length of stay (aOR = 0.78, 95% CI: 0.67-0.91, p = 0.001) were significantly less in the robotic than the laparoscopic group. In addition, robotic surgery was associated with significantly higher total hospital costs ($26.06 USD greater cost; 95% CI: 21.35-30.77 USD, p < 0.001). LIMITATIONS: The analysis was limited by its retrospective and observational nature, potential coding errors, and the lack of intraoperative factors such as operative time, laboratory measures, and information on surgeons’ experience. CONCLUSIONS: In United States, patients with colorectal cancer ≥ 75 years who were undergoing tumor resections, compared to conventional laparoscopic surgery, robotic surgery is associated with better inpatient outcomes in terms of complication rate and risk of prolonged length of stay, especially among patients with colon cancer. However, robotic surgery is associated with higher total hospital costs.

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A Concept for Preoperative and Intraoperative Molecular Imaging and Detection for Assessing Extent of Disease of Solid Tumors

Hitchcock,

Chapman,

Mojzisik

et al. 2024

Oncol.Rev.

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The authors propose a concept of “systems engineering,” the approach to assessing the extent of diseased tissue (EODT) in solid tumors. We modeled the proof of this concept based on our clinical experience with colorectal carcinoma (CRC) and gastrinoma that included short and long-term survival data of CRC patients. This concept, applicable to various solid tumors, combines resources from surgery, nuclear medicine, radiology, pathology, and oncology needed for preoperative and intraoperative assessments of a patient’s EODT. The concept begins with a patient presenting with biopsy-proven cancer. An appropriate preferential locator (PL) is a molecule that preferentially binds to a cancer-related molecular target (i.e., tumor marker) lacking in non-malignant tissue and is the essential element. Detecting the PL after an intravenous injection requires the PL labeling with an appropriate tracer radionuclide, a fluoroprobe, or both. Preoperative imaging of the tracer’s signal requires molecular imaging modalities alone or in combination with computerized tomography (CT). These include positron emission tomography (PET), PET/CT, single-photon emission computed tomography (SPECT), SPECT/CT for preoperative imaging, gamma cameras for intraoperative imaging, and gamma-detecting probes for precise localization. Similarly, fluorescent-labeled PLs require appropriate cameras and probes. This approach provides the surgeon with real-time information needed for R0 resection.

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Minimally invasive surgery improves survival after colorectal cancer resection

Cited by 3 publications

References 3 publications

Outcomes of robot‐assisted versus laparoscopic surgery for colorectal cancer in morbidly obese patients: A propensity score‐matched analysis of the US Nationwide Inpatient Sample

Outcomes of robot‐assisted versus laparoscopic surgery for colorectal cancer in morbidly obese patients: A propensity score‐matched analysis of the US Nationwide Inpatient Sample

Outcomes of Robot-Assisted Versus Laparoscopic Surgery for Colorectal Cancer in Adults ≥ 75 Years Old: A Propensity Score Matched Analysis of the US Nationwide Inpatient Sample

A Concept for Preoperative and Intraoperative Molecular Imaging and Detection for Assessing Extent of Disease of Solid Tumors

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