Robotic Versus ‘Open’ Hepatectomy for Metastatic Colorectal Adenocarcinoma
Posted: Tuesday, June 23, 2020
Patients with metastatic colorectal cancer began adjuvant chemotherapy earlier when undergoing robotic hepatectomy than with ‘open’ hepatectomy, according to a study presented as part of the 2020 virtual Digestive Disease (DDW; Abstract Tu2044) and published in the journal Gastroenterology. Iswanto Sucandy, MD, of the Advent Health Medical Group, Tampa, Florida, and colleagues said patients treated with robotic surgery also spent less time in the ICU and were more likely to have an earlier recovery.
For this study, the authors prospectively followed 46 consecutive patients with metastatic colorectal cancer to the liver. Of them, 30 patients underwent robotic hepatectomy, and 16 underwent ‘open’ hepatectomy. Using student t-test and chi-square analysis, the demographic and perioperative outcomes were identified. To estimate median survival, a Kaplan-Meier analysis was used. Patients in both treatment groups were of a similar age (62 vs. 68 years) and had the same MELD (Model for End-Stage Liver Disease) score (3).
In terms of blood loss and operative duration, the groups did not significantly differ. However, the tumor size for patients undergoing ‘open’ hepatectomy were significantly larger than for patients undergoing robotic hepatectomy (5 cm vs. 2 cm). Also, patients in the ‘open’ hepatectomy group had a hospital stay of 8 days compared with 4 days for the robotic hepatectomy group.
Finally, patients undergoing robotic hepatectomy spent less time in the ICU (0 days vs. 1 day). And, the time to begin adjuvant chemotherapy was shorter for patients undergoing robotic hepatectomy (1.6 months vs. 2.4 months).
“The use of a robotic platform to hepatic resections facilitates earlier recovery and more importantly propels patients to the next phase of their treatment sooner,” the authors concluded.
Disclosure: The study authors reported no conflicts of interest.