Benefits of minimally invasive surgery for rectal cancer in older adults compared with younger adults: a retrospective study

Randomized research demonstrated that robotic surgery was oncologically safe and beneficial in the short term. We investigated whether older adults benefit from robotics more than younger adults do in terms of short-term outcomes. We identified all older (>= 70 years old) and younger (<= 70) adults with rectal cancer treated with resection between 2019 and 2022 from an institutional database. We assessed the short-term post-operative 90-day outcomes, which included the first bowel movement, length of hospital duration, sepsis, and harvested lymph node on an age-based differentiation. The key outcomes were complications and grades III-IV on the Clavien-Dindo scale. We identified 298 individuals treated with oncologic resection of rectal cancer: 108 (36.6%) were older adults, while 190 (63.4%) were younger adults. Older adults treated with robotic surgery include 45 (41.6%), whereas 63 (58.3%) older adults were treated with laparoscopic surgery, and 85 (44.7%) younger adults were treated with robotic surgery, while 105 (55.2%) younger adults were treated with laparoscopic surgery. The Clavien-Dindo grading system exposes a substantial P < 0.05 in younger group, whereas grade III-IV patients are seen more frequently in laparoscopic surgery than robotic surgery. Younger and older persons both benefited differently from robotic surgery when compared to laparoscopic surgery in terms of major post-operative complications.

Automated summary

Randomized research showed that robotic surgery is safe and beneficial for oncological purposes in the short term. This study aimed to investigate if older adults derive greater benefits from robotic surgery compared to younger adults in terms of short-term outcomes. A retrospective analysis was performed on all rectal cancer patients aged 70 years and above (older adults) and below 70 years (younger adults) who underwent resection from 2019 to 2022. Short-term post-operative outcomes, including bowel movement, hospital stay duration, sepsis, and lymph node harvest, were evaluated based on age. The key outcomes assessed were complications and grades III-IV according to the Clavien-Dindo scale. Of the 298 individuals treated for rectal cancer, 108 (36.6%) were older adults and 190 (63.4%) were younger adults. Among older adults, 45 (41.6%) underwent robotic surgery while 63 (58.3%) underwent laparoscopic surgery. Among younger adults, 85 (44.7%) underwent robotic surgery while 105 (55.2%) underwent laparoscopic surgery. The analysis demonstrated a significant difference (P < 0.05) in the Clavien-Dindo grading system, with a higher proportion of grade III-IV patients in the laparoscopic surgery group compared to the robotic surgery group. Both younger and older individuals experienced different benefits from robotic surgery compared to laparoscopic surgery in terms of major post-operative complications.