Our Summary

This study looked at the differences in outcomes for patients who had surgery for colon cancer on either the right or left side of the colon. Previous studies had found that patients who had surgery on the right side had higher rates of a condition called ileus (a disruption in the normal movement of the digestive system), while those who had surgery on the left side had higher rates of wound infection and leakage from the site where the surgeon had reconnected the bowel.

However, these previous studies didn’t consider operations carried out using robotic surgery. This study therefore compared outcomes for patients who had either traditional laparoscopic surgery (where small incisions are made and a camera is used to guide the surgeon) or robotic surgery (where a robot controlled by the surgeon carries out the procedure).

The study found that overall, patients who had surgery on the right side had higher rates of complications after surgery, but there wasn’t a significant difference in the rates of ileus, wound infection, time taken for normal bowel function to return, length of hospital stay or need for readmission within 30 days.

However, patients who had laparoscopic surgery were found to have a 2.5 times higher likelihood of complications compared to those who had robotic surgery.

The study also specifically looked at outcomes for patients who had robotic surgery, and found no significant difference in outcomes depending on whether the surgery was on the right or left side of the colon.

In conclusion, the study suggests that using robotic surgery could reduce the differences in outcomes seen in previous studies between right and left-sided colon cancer surgery.

FAQs

  1. What types of surgical procedures were compared in this study on colectomy for cancer?
  2. What were the findings from the study in terms of postoperative complications for laparoscopic and robotic surgeries?
  3. Did the study find any significant differences in outcomes between laparoscopic and robotic right and left colectomies for cancer?

Doctor’s Tip

One helpful tip that a doctor might tell a patient about colectomy is to consider robotic surgery as it may have better short-term outcomes compared to laparoscopic surgery. Robotic surgery for colectomy could potentially reduce the risk of postoperative complications and improve overall recovery. It is important for patients to discuss the different surgical options with their healthcare provider to determine the best approach for their individual case.

Suitable For

Patients who are typically recommended colectomy are those with colorectal cancer, inflammatory bowel disease, severe diverticulitis, or other conditions that cannot be effectively treated with more conservative measures. In this study, patients who underwent minimally invasive right or left colectomies for cancer were compared, with a sub-analysis of robotic procedures. The study found that there were differences in short-term outcomes between laparoscopic and robotic surgeries, with robotic surgery showing lower rates of overall complications compared to laparoscopic surgery. This suggests that robotic surgery may be a better option for certain patients who require colectomy.

Timeline

Before colectomy:

  • Patient undergoes preoperative evaluation and consultation with a surgeon
  • Patient may undergo preoperative tests and imaging studies
  • Patient may need to follow a specific diet or bowel preparation regimen
  • Patient may need to temporarily stop certain medications
  • Patient receives anesthesia before surgery

After colectomy:

  • Patient is monitored closely in the postoperative period for any complications
  • Patient may have a temporary ileostomy or colostomy
  • Patient may experience pain, fatigue, and discomfort
  • Patient gradually resumes eating and drinking
  • Patient may need to stay in the hospital for a few days to a week
  • Patient may need to follow a specific diet and take medications
  • Patient may need to gradually increase physical activity and avoid heavy lifting
  • Patient may have follow-up appointments with the surgeon for monitoring and evaluation of recovery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a colectomy procedure?
  2. How does the recovery process differ between laparoscopic and robotic colectomy procedures?
  3. What is the success rate of colectomy procedures for treating cancer?
  4. How long can I expect to be in the hospital following a colectomy procedure?
  5. Will I need to make any changes to my diet or lifestyle after the procedure?
  6. What is the long-term outlook for patients who undergo a colectomy for cancer?
  7. How often will I need to follow up with you after the procedure?
  8. Are there any alternative treatment options to consider before proceeding with a colectomy?
  9. What is your experience and success rate with performing colectomy procedures, particularly robotic procedures?
  10. Are there any specific instructions or precautions I should be aware of before and after the colectomy procedure?

Reference

Authors: Nasseri Y, Kasheri E, Oka K, Cox B, Cohen J, Ellenhorn J, Barnajian M. Journal: J Robot Surg. 2022 Aug;16(4):875-881. doi: 10.1007/s11701-021-01310-8. Epub 2021 Sep 28. PMID: 34581955