Our Summary

This study investigated factors that may predict whether rectal cancer patients would undergo a particular type of surgery called robotic-assisted proctectomy. The research analyzed data from over 67,000 patients with rectal cancer from the National Cancer Database from 2010 to 2019. Some factors that made it more likely for a patient to have this type of surgery included being younger than 50, being male, being of Asian descent, having private insurance, being treated for rectal cancer between 2015 and 2019, having stage III disease, receiving a certain type of radiation therapy before surgery, and having a specific procedure called pull-through coloanal anastomosis. On the other hand, patients who were Black or American Indian, had a high Charlson comorbidity index score (a measure of how severe a patient’s other health problems are), lived in rural areas, were uninsured, or had a procedure called pelvic exenteration were less likely to have robotic-assisted proctectomy. The study highlights disparities in access to this surgical method based on race, insurance status, and other factors.

FAQs

  1. What factors increase the likelihood of a patient undergoing robotic-assisted proctectomy for rectal cancer?
  2. Are there certain demographics that are less likely to have a robotic-assisted proctectomy according to this study?
  3. What does the study suggest about disparities in access to robotic-assisted proctectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about proctectomy is to ask about the possibility of undergoing robotic-assisted surgery, as it may offer certain benefits such as shorter hospital stays, less pain, and quicker recovery compared to traditional open surgery. It’s important for patients to discuss all available options with their healthcare team to determine the best course of treatment for their individual case.

Suitable For

Overall, patients who are younger, male, of Asian descent, have private insurance, are treated in more recent years, have stage III disease, received specific pre-surgery radiation therapy, and have a certain type of procedure may be recommended for robotic-assisted proctectomy. Conversely, patients who are Black or American Indian, have a high comorbidity index score, live in rural areas, are uninsured, or have a different type of procedure may be less likely to undergo this surgery.

Timeline

Before proctectomy:

  • Patient is diagnosed with rectal cancer
  • Patient undergoes various tests and consultations to determine the best treatment plan
  • Patient may undergo chemotherapy and/or radiation therapy to shrink the tumor before surgery
  • Patient discusses surgical options with their healthcare team, including robotic-assisted proctectomy
  • Patient prepares for surgery by following specific pre-operative instructions

After proctectomy:

  • Patient undergoes robotic-assisted proctectomy surgery to remove the rectal cancer
  • Patient recovers in the hospital for a period of time, typically a few days to a week
  • Patient may experience pain, discomfort, and side effects from the surgery
  • Patient begins a recovery process that may include physical therapy, dietary changes, and monitoring for complications
  • Patient follows up with their healthcare team for post-operative care, including monitoring for recurrence and potential further treatment.

What to Ask Your Doctor

  1. What is a proctectomy and why is it being recommended for me?
  2. What are the different types of proctectomy surgeries available and why is robotic-assisted proctectomy being considered for me?
  3. What are the potential benefits of robotic-assisted proctectomy compared to other types of surgery?
  4. What are the potential risks and complications associated with robotic-assisted proctectomy?
  5. How experienced are you in performing robotic-assisted proctectomy procedures?
  6. What is the recovery process like after robotic-assisted proctectomy?
  7. Are there any long-term effects or considerations I should be aware of after undergoing robotic-assisted proctectomy?
  8. How will my quality of life be affected after robotic-assisted proctectomy?
  9. Are there any alternative treatments or surgical options available for my condition?
  10. Are there any specific factors or characteristics about my case that make me a good candidate for robotic-assisted proctectomy?

Reference

Authors: Emile SH, Garoufalia Z, Gefen R, Dasilva G, Wexner SD. Journal: Am Surg. 2025 Apr;91(4):528-538. doi: 10.1177/00031348241304013. Epub 2024 Dec 2. PMID: 39621833