The Usefulness of Robot-assisted Surgery for Elderly Colorectal Cancer Patients.

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.