The Role of Minimally Invasive Surgery and Outcomes in Colorectal Cancer

Kwon, David S.; Chang, George J.

doi:10.7812/tpp/11-091

Cited by 7 publications

(4 citation statements)

References 45 publications

(39 reference statements)

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“…It involved mobilization of the right and sigmoid colon (3). Since then, many studies have shown the feasibility and safety of robotic colorectal surgery (4)(5)(6)(7). Recently, three meta-analyses comparing robotic rectal cancer surgery with laparoscopic surgery have shown lower conversion rates (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Total robotic radical rectal resection with da Vinci Xi system: single docking, single phase technique

Tamhankar

Jatal

Saklani

2016

Robotics Computer Surgery

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The latest Da Vinci Xi system has made total robotic rectal surgery feasible in single docking and single phase. With the new system, four arm total robotic rectal surgery may replace the hybrid technique of laparoscopic and robotic surgery for rectal malignancies. The learning curve for the new system appears to be shorter than anticipated. Early perioperative and oncological outcomes of total robotic rectal surgery with the new system are promising. Copyright © 2016 John Wiley & Sons, Ltd.

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Section: Introductionmentioning

confidence: 99%

Total robotic radical rectal resection with da Vinci Xi system: single docking, single phase technique

Tamhankar

Jatal

Saklani

2016

Robotics Computer Surgery

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“…This further supports that a major contributing factor to the relatively low rates of guideline concordant adjuvant treatment described in this patient cohort is prohibitively high costs incurred by patients within the Ukrainian healthcare system. Surgeons also reported limitations in equipment availability affecting patient care, citing inability to offer minimally invasive laparoscopic or robotic surgery, which have shown to be safe options with improved short term outcomes compared to open surgery [23, 24].…”

Section: Discussionmentioning

confidence: 99%

The Current Landscape of Staging and Treatment of Colorectal Cancer in a Region of Ukraine: a Mixed Methods Study

Shabat

Semeniv³

et al. 2020

World j. surg.

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Background In Ukraine, the 1‐year mortality for colorectal cancer is much higher than that seen in high‐income countries. We investigated practice patterns of colorectal cancer treatment in a region of Ukraine to account for high mortality rates. Methods An explanatory sequential mixed methods design was used. Data from patients who underwent surgery for colorectal cancer in Ivano‐Frankivsk from 2011 to 2015 were collected via retrospective chart review, and descriptive statistics were calculated. Semi‐structured interviews were performed with local practicing surgeons and oncologists until thematic saturation was reached. Results A total of 960 patients who underwent surgery were identified in the Ivano‐Frankivsk region with colon (689) or rectal (271) cancer. 11.7% of patients underwent preoperative CT of the abdomen and pelvis, and only 1.7% underwent CT of the chest. 4.1% of patients underwent a complete preoperative colonoscopy, while 31.0% had incomplete colonoscopies. Postoperatively, 31.1% of patients with stage II colon cancer and 43.9% of patients with stage III colon cancer underwent adjuvant chemotherapy. For patients with stage II and III rectal cancers, 20.9% and 33.3% underwent chemotherapy, while 68.4% and 66.7% underwent radiation therapy, respectively. Fifteen physicians completed interviews. Two major themes emerged regarding physician perceptions on providing colorectal cancer care: lack of resources and systems level issues negatively impacting patient care. Conclusion In this region in Ukraine, staging practices for colorectal malignancies are inconsistent and inadequate, and adjuvant treatments are varied. This is likely attributable to the lack of resources facing providers and the prohibitively high cost of care to patients.

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“…With this gradual shift toward a more minimally invasive approach, studies have shown fewer complications, shorter lengths of stay, and improved oncologic results for patients undergoing laparoscopic colorectal surgery when compared with the standard open approach. [3][4][5][6] More recently, robotic colon resections have become utilized by many colorectal surgeons; however, the data are mixed on whether robotic surgery should be adopted as the standard, as it has similar oncologic outcomes but longer operative times and higher cost. [7][8][9] Although the literature has supported the movement toward minimally invasive colon surgery in the general population, there have not been studies that examine the outcomes of colorectal procedures in the Department of Veterans Affairs (VA) system.…”

Section: Introductionmentioning

confidence: 99%

Outcomes and Trends in Colorectal Surgery in U.S. Veterans: A 10-year Experience at a Tertiary Veterans Affairs Medical Center

Napolitano

Skancke

Walters

et al. 2020

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Introduction:The past decade has witnessed numerous advances in colorectal surgery secondary to minimally invasive surgery, evidence-based enhanced recovery programs, and a growing emphasis on patient-centered outcomes. The purpose of this study is to benchmark outcomes and experiences of patients undergoing colorectal surgery at a tertiary Veterans Affairs Medical Center for a 10-year period. Materials and Methods: Veterans who underwent nonemergent colorectal procedures between 2008 and 2018 were identified using targeted Current Procedural Terminology (CPT) codes and the Computerized Patient Record System. Patient outcomes were captured using the Veterans Affairs Surgical Quality Improvement Program and focused on length of stay and aggregate postoperative morbidity profiles. SAS Ò Version 9.4 (SAS Institute Inc., Cary, NC) was used for all data analysis with P < .05 used to indicate significance. Results: In total, 327 patients underwent colon/rectal resection at our medical center. Of whom 95% of patients were male and the average age was 66 years. The median length of stay after surgery was 8 days. Within the 30day postoperative period, the composite morbidity score was 24.1%: most notable being superficial surgical site infections (6.5%), wound dehiscence (4.6%), and pneumonia (3.1%). Over the course of the study period, the laparoscopic approach increased in utilization, with 22.2% of cases performed laparoscopically in 2008 that rose to 61.1% in 2018. Conclusion: Cataloging this decade of practice provides a foundation for future changes in the field of colorectal surgery and in the treatment of veterans. Understanding historical outcomes should help identify areas for ongoing process improvement and guide targeted approaches to quality metrics.

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The Role of Minimally Invasive Surgery and Outcomes in Colorectal Cancer

Cited by 7 publications

References 45 publications

Total robotic radical rectal resection with da Vinci Xi system: single docking, single phase technique

Total robotic radical rectal resection with da Vinci Xi system: single docking, single phase technique

The Current Landscape of Staging and Treatment of Colorectal Cancer in a Region of Ukraine: a Mixed Methods Study

Outcomes and Trends in Colorectal Surgery in U.S. Veterans: A 10-year Experience at a Tertiary Veterans Affairs Medical Center

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