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Colorectal surgery in elderly patients: our experience with DaVinci Xi® System

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Abstract

Background

Robotic technology for colorectal surgery was introduced by Weber in 2002 to improve the benefits of the minimally invasive surgery already offered by the laparoscopic approach.

Aims

To evaluate the feasibility and the efficacy of the application of robotic surgery in elderly patients affected by colorectal diseases.

Methods

We reported the outcomes obtained during our first 50 colorectal robotic surgical performances with DaVinci Xi® System, and we compared the results assessed for patients younger or older than 70 years.

Results

We examined 28 patients younger and 22 older than 70 years who underwent colorectal robotic surgery in our institution from September 2014 to June 2016. We performed 15 right colectomies, 20 left colectomies, 15 rectal resections. Mean ASA score was significantly higher in the Elderly Group. No statistically significant differences have been revealed in terms of post-operative morbidity, hospital stay, first diet intake, first flatus canalization and oncological outcome.

Discussion

According to the prolonged operative time, robotic technology was initially reserved to young patients with good performance status in order to avoid systemic failures in elderly patients suffering from pre-existent comorbidities. Otherwise, once robotic approach safety and benefits in terms of better systemic outcomes were demonstrated, it started to be performed in elderly patients with satisfactory outcomes.

Conclusion

Our experience revealed that robotic surgical approach is safe, feasible and offers many systemic benefits in elderly patients also with high ASA score. Age alone has not to be considered as exclusion criteria for robotic approach.

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Abbreviations

CRS:

Colorectal surgery

BMI:

Body mass index

ASA:

American Society of Anaesthesiologists

YG:

Younger Group

EG:

Elderly Group

RC:

Right colectomy

CME:

Complete mesocolic excision

LC:

Left colectomy

RR:

Rectal resection

LNs:

Lymph nodes

AJCC:

American Joint Committee on Cancer

NCCN:

National Comprehensive Cancer Network

SUL:

Spino—umbilical line

MCL:

Middle—clavicular line

TUL:

Transverse umbilical line

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Funding

The authors declare that they have received no funding for the study.

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Authors and Affiliations

  1. Department of Surgery, University of Eastern Piedmont - AOU “Maggiore della Carità” Hospital, Corso Mazzini 11, 28100, Novara, Italy

    A. Oldani, P. Bellora, M. Monni & S. Gentilli

  2. Department of Clinical Medicine and Surgery, University “Federico II”, Naples, Italy

    B. Amato

Authors
  1. A. Oldani
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  2. P. Bellora
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  3. M. Monni
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  4. B. Amato
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  5. S. Gentilli
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Corresponding author

Correspondence to A. Oldani.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, ethics committee approval is not required.

Statement of human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Oldani, A., Bellora, P., Monni, M. et al. Colorectal surgery in elderly patients: our experience with DaVinci Xi® System. Aging Clin Exp Res 29 (Suppl 1), 91–99 (2017). https://doi.org/10.1007/s40520-016-0670-y

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  • DOI: https://doi.org/10.1007/s40520-016-0670-y

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