Purpose In recent years, colorectal cancer surgery has benefitted from new techniques such as laparoscopy and robotic surgery. However, many treatment disparities exist among different centers for patients affected by the same kind of tumors. Methods Forty-five (41%) open (OCO) vs. 30 (28%) laparoscopic (LCO) vs. 34 (31%) robotic-assisted (RCO) colectomies and 34 (40%) open (ORR) vs. 52 (60%) robotic (ROR) rectal resections performed during a 15-month period, in elective setting, were compared. Patients presenting contraindications for minimally invasive procedures were excluded from the study, so that all the enrolled patients were suitable for either of the surgical procedures. Results Overall morbidity rates were similar among groups. Perioperative mortality was nil. No significant differences were noted as for total number of lymph nodes harvested between arms. Mean time (days) to first bowel movement to gas was 3.3 vs. 2.3 vs. 2.6 for OCO, LCO, and RCO, respectively (p<0.001), and 3.3 vs. 2.0 for ORR and ROR, respectively (p=0.003). Among several European Organization in Research and Treatment of Cancer QLQ-C30 functional scales considered only physical functioning was significantly better at 30 days for RCO vs. OCO (96.3±10 RCO vs. 85.5±12.6 OCO; p=0.015). Robotic surgery was much more expensive in comparison to open as well as laparoscopic procedures. Conclusions Laparoscopic and robotic surgeries for colorectal cancer present both the same advantages in comparison to open procedures in terms of faster recovery. However, our data do not seem to support the routine use of RCO as a cost-effective procedure.
Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approaches / E. Bertani, A. Chiappa, R. Biffi, P.P. Bianchi, D. Radice, V. Branchi, E. Cenderelli, I. Vetrano, S. Cenciarelli, B. Andreoni. - In: INTERNATIONAL JOURNAL OF COLORECTAL DISEASE. - ISSN 0179-1958. - 26:10(2011 Oct), pp. 1317-1327.
|Titolo:||Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approaches|
CHIAPPA, ANTONIO COSTANZO (Secondo)
ANDREONI, BRUNO GUIDO (Ultimo)
|Parole Chiave:||Colorectal cancer; Robotic surgery; Laparoscopic surgery; Quality of life; Cost analysis; Appropriateness|
|Settore Scientifico Disciplinare:||Settore MED/18 - Chirurgia Generale|
|Data di pubblicazione:||ott-2011|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s00384-011-1270-0|
|Appare nelle tipologie:||01 - Articolo su periodico|