Colorectal robotic surgery: INCA's experience

• Published in: Journal of Coloproctology 2019-04, Vol.39 (2), p.153-158
• Main Authors: Valadão, Marcus, Câmara, Eduardo Rodrigues Zarco da, Fong, Jensen Mifont, Araujo, Rodrigo Otavio, Linhares, Eduardo, Jesus, José Paulo, Albagli, Rafael
• Format: Article
• Language: English
• Subjects: Cirurgia robótica colorretal; Colon neoplasms; Colorectal robotic surgery; GASTROENTEROLOGY & HEPATOLOGY; Morbidade e mortalidade em cirurgia robótica; Morbidity and mortality in robotic surgery; Neoplasias do cólon; Neoplasias Retais; Original Article; Rectal neoplasms; SURGERY
• ISSN: 2237-9363; 2317-6423; 2317-6423
• DOI: 10.1016/j.jcol.2019.01.002

Minimally invasive surgery has revolutionized surgical management in the treatment of colorectal neoplasms, reducing morbidity and mortality, hospitalization, inactivity time and minimizing cost, as well as providing adequate oncological results when compared to the conventional approach. Robotic surgery, with Da Vinci Platform, emerges as a step ahead for its potentials. The objective of this article is to report the single institutional experience with the use of Da Vinci Platform in robotic colorectal surgeries performed at a reference center in oncological surgery in Brazil. A retrospective cohort study was conducted based on the prospective database of patients from the institution submitted to robotic surgery for treatment of colorectal cancer from July 2012 to September 2017. Clinical and surgical variables were analyzed as predictors of morbidity and mortality. A total of 117 patients underwent robotic surgery. The complications related to surgery occurred in 33 patients (28%), the most frequent being anastomotic fistula and surgical wound infection, which corresponded to 11% and 3%, respectively. Conversion rate was 1.7%. Median length of stay was 5 days. The only variable associated with increase of complications and death risk was BMI >30, with p-value of 0.038 and 0.027, respectively. Robotic surgery is safe and feasible for approaching colorectal cancer surgeries, presenting satisfactory results regarding length of hospital stay and rate of operative complications, as well as presenting a low rate of conversion. Obesity has been shown to be a risk factor for surgical complication in robotic colorectal surgery. A cirurgia minimamente invasiva revolucionou o tratamento cirúrgico no manejo das neoplasias colorretais, reduzindo a morbidade e mortalidade, a hospitalização, o tempo de inatividade e minimizando os custos, além de fornecer resultados oncológicos adequados quando comparada à abordagem convencional. A cirurgia robótica, com a Plataforma Da Vinci, surge como um passo à frente por seus potenciais. O objetivo deste artigo é relatar a experiência institucional única com o uso da Plataforma Da Vinci em cirurgias robóticas colorretais realizadas em um centro de referência em cirurgia oncológica no Brasil. Foi realizado um estudo de coorte retrospectivo, baseado na base de dados prospectiva de pacientes da instituição que foram submetidos à cirurgia robótica para tratamento de câncer colorretal, de julho de 2012 a setembro de 2017. As variávei