BACKGROUND/AIM:The usefulness of robot-assisted surgery for elderly colorectal cancer patients remains controversial. The aim of this study was to examine the impact of the surgical approach on short-term prognosis in patients aged ≥80 years. PATIENTS AND METHODS:A total of 1,115 colorectal cancer patients aged ≥80 years who underwent surgery at 6 hospitals between 2016 and 2024 were included in the study. Patients were divided into three groups according to surgical approach: robotic surgery (R group, n=55), laparoscopic surgery (L group, n=910), and open surgery (O group, n=150). Patient characteristics and surgical outcomes were compared among the three groups. RESULTS:The O group had higher proportions of patients with a body mass index (BMI) <25 kg/m2 (R vs. L vs. O: 72.7% vs. 80.8% vs. 87.3%, p=0.040), a performance status ≥3 (9.1% vs. 18.6% vs. 27.3%, p=0.006), an operation time <240 min (47.3% vs. 59.1% vs. 79.3%, p<0.001), and postoperative complications (9.1% vs. 23.0% vs. 27.3%, p=0.022). Multivariable analysis demonstrated that robotic surgery [odds ratio (OR)=0.243, 95% confidence interval (CI)=0.088-0.668, p=0.006] and BMI <25 kg/m2 (OR=0.626, 95% CI=0.419-0.936, p=0.032) were associated with a reduced risk of postoperative complications. CONCLUSION:Robotic-assisted colorectal surgery in elderly patients is safe, with relatively few complications.
Surgical outcomes have improved remarkably through specialist experience and certification; however, regional physicians have limited opportunities to publish because of the lack of accessible databases. The aim of this study was to examine whether establishing a large-scale database in regional areas could enhance academic output and thus support specialist certification. The databases of a university hospital and several regional general hospitals were unified in 2016. The period before database unification was termed the early period (E period) and that after unification was termed the late period (L period). The number of specialist certifications acquired was compared between the periods. The numbers of the following increased from the E period to the L period: academic presentations (86 vs. 186), publication of original articles (3 vs. 64), cases analyzed (5 vs. 20), papers written by new authors (2 vs. 20), Endoscopic Surgical Skill Qualification System-certified surgeons (2 vs. 12), and Board-certified Surgeons in Gastroenterology (2 vs. 12). Moreover, the mean number of years of clinical experience that it took for specialist qualifications to be obtained decreased from 14 years in the E period to 9 years in the L period. Establishing a database across regional areas promoted the presentation and publication of research by early-career clinicians, thereby supporting the development of medical specialists.
The Endoscopic Surgical Skill Qualification System (ESSQS) was established in Japan to provide an objective measure of the skills of laparoscopic surgeons. This study aimed to assess the effects of the ESSQS on short- and long-term outcomes of laparoscopic right colectomy. We retrospectively reviewed the data of 671 patients with right colon cancer who underwent laparoscopic surgery between 2016 and 2023. Patients were divided into an expert group (n = 194) and a non-expert group (n = 477) based on whether surgery was performed by an ESSQS-qualified surgeon. After propensity score matching, 167 patients in each group were matched. The short- and long-term outcomes were compared between the groups. Before matching, the expert group showed significantly greater frequencies of preoperative treatment (3.1
There are limited reports on the safety of robotic surgery compared to laparoscopic surgery for colon cancer. In this study, we examined the impact of robotic surgery on the short-term outcomes of colon cancer using a multicenter database. We retrospectively reviewed 4084 consecutive patients with colon cancer who underwent minimally invasive surgery between April 2016 and December 2025. Patients were classified into two groups according to the surgical approach: robotic surgery (R group, n = 438) and laparoscopic surgery (L group, n = 3646). Propensity score matching was applied to minimize selection bias and balance the covariates. Finally, 438 patients in each group were matched for analysis. The clinicopathological features were compared between the groups. After matching, blood loss was lower (10 mL vs. 15 mL, p = 0.027), the conversion rate was lower (0.4
Postoperative complications may affect the long-term outcomes after colorectal cancer (CRC) surgery. This multicenter study compared prognostic factors for overall survival (OS) in younger (≤ 74 years) and older (≥ 75 years) patients after curative resection for CRC, focusing on the 1-year and post-1-year outcomes. We analyzed data from 1582 patients who underwent curative surgery for CRC at six hospitals between April 2016 and December 2019. Kaplan–Meier and Cox models were used to identify the risk factors for complications and survival. Older patients had a significantly worse overall survival (OS) and survival beyond the 1-year landmark. Postoperative complications were associated with increased 1-year mortality in both age groups. In younger patients, survival beyond 1 year was associated with a positive N status and a low BMI. In contrast, in older patients, postoperative complications remained associated with survival beyond the 1-year landmark, along with a male sex, positive N status, and poor ASA-PS. The prolonged impact of complications on survival in older patients with CRC underscores the need for age-specific surgical strategies and proactive complication management.
