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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 10/2011

01-10-2011 | Original Article

Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approaches

Authors: Emilio Bertani, Antonio Chiappa, Roberto Biffi, Paolo Pietro Bianchi, Davide Radice, Vittorio Branchi, Elena Cenderelli, Irene Vetrano, Sabine Cenciarelli, Bruno Andreoni

Published in: International Journal of Colorectal Disease | Issue 10/2011

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Abstract

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.
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Metadata
Title
Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approaches
Authors
Emilio Bertani
Antonio Chiappa
Roberto Biffi
Paolo Pietro Bianchi
Davide Radice
Vittorio Branchi
Elena Cenderelli
Irene Vetrano
Sabine Cenciarelli
Bruno Andreoni
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 10/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-011-1270-0

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