Seung Yoon Yang, Gyoung Tae Noh, Youn Young Park, Jiho Yoon, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Byung Soh Min, Kang Young Lee, Nam Kyu Kim. Yonsei University College of Medicine
Purpose: Robotic surgery (RS) is an emerging technology that has technical advantages over traditional laparoscopic surgery (LS). In colorectal cancer, robotic surgery has been used increasingly but there is still no consensus on its comparative merit compared with LS, especially in colon cancer than rectal cancer. The aim of this study was to investigate surgical and oncologic outcome after RS for colon cancer in comparison with open surgery (OS) and LS. Further, we assessed the impact on inflammatory reaction according to the surgical modalities.
Methods: Using propensity scores for adjustment of age, gender, American society of anesthesiologists (ASA) grade, body mass index (BMI), location of primary tumor, pathologic stage, extent of resection and operating surgeon, a well-balanced cohort with 66 patients in each group was created by matching each patient who underwent RS as the study group with one who underwent OS, LS as the control group (RS:OS=1:1, RS:LS=1:1 match). Surgical and long-term oncological results were compared between the 3 groups. In addition, to access the difference of inflammatory reaction between the groups, biochemical indices (leukocyte count, neutrophil count and minimal prognostic nutritional index (PNI)) were compared.
Results: In RS and LS, time to first flatus and resumed soft diet were significantly shorter than in OS. LS shortened postoperative hospital stay than OS, significantly. RS did not show significant difference of postoperative hospital stay compared with OS. There was no difference with significance in patients’ recovery between RS and LS. Comparing postoperative inflammatory indices of leukocyte and neutrophil between the groups, RS and LS showed significantly higher leukocyte and neutrophil count than OS. Between RS and LS, there was no significant difference. Analyzing PNI, RS showed significantly higher result than LS and OS. In complication rate and oncologic outcome (5-year disease free survival and overall survival), no significant difference was observed among three groups.
Conclusion: In this study, RS showed better patients’ recovery and less inducement of inflammatory reaction after surgery than OS. In addition, PNI, an indicator for immune-nutritional status, was relatively preserved after RS than OS and LS. Further study is required to clarify this issue.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 77379
Program Number: P692
Presentation Session: Poster (Non CME)
Presentation Type: Poster