Factors affecting the selection of minimally invasive surgery for stage 0/I colorectal cancer.
OBJECTIVE
To evaluate which factors affect selection of minimally invasive surgery (MIS) or open procedures for patients with stage 0/I colorectal cancer. The short-term and oncologic outcomes of MIS were also compared to those of open procedures.


METHODS
A total of 181 consecutive patients underwent either MIS (laparoscopy: n = 146, robot: n = 8) or open (n = 27) colorectal resection for stage 0/I disease.


RESULTS
Elderly patients (≥80) were more common in the open procedure group (22.2%) than the MIS (7.8%) group (p = .02). Surgeon A performed more MIS procedures than surgeon B (p = .003). There were no differences in the 30-day complication rate between open (37%) and MIS (21.4%) groups (p = .08). Time to tolerable diet (p = .002) and length of hospital stay (p = .02) were shorter in the MIS group. There were no differences in the cancer-specific survival (p = .71) and recurrence-free survival rates (p = .67) between open and MIS procedures.


CONCLUSIONS
Patient factors (old age) and surgeon factors (surgeon B) were barriers to the choice of MIS. Old age and operating surgeons were not associated with adverse 30-day complications. The short-term and oncologic outcomes of MIS were comparable to those of open procedures. It is safe to expand the indication for MIS to elderly patients.
Division of Gastrointestinal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Dong Hyun
DH
Kim
Division of Gastrointestinal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Ik Yong
IY
Kim
Division of Gastroenterology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
Bo Ra
BR
Kim
Division of Gastrointestinal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea. Electronic address: youngwkim@yonsei.ac.kr.
Young Wan
YW
Kim
D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009367:Neoplasm Staging
Colorectal neoplasms; Minimally invasive surgical procedures; Neoplasm staging; Surgeons