高齢者大腸癌に対するロボット支援手術の短期成績

Short-term outcomes of robotic surgery for elderly colorectal cancer patients

◆要旨：ロボット支援手術を含む低侵襲手術の進歩は目覚ましいが，高齢者患者におけるエビデンスは未だ少ない．当院でロボット支援大腸癌手術を施行した80歳以上の患者（O群：56例）と80歳未満の患者（Y群：131例）の短期成績を比較検討した．O群で有意に併存症をもつ患者が多く，腫瘍径が大きい進行癌が多かった．直腸癌はO群で有意に永久人工肛門造設を伴う術式が多く（p＝0.012），術後在院日数が長かった（10日vs 7日，p＝0.001）．手術時間，出血量，術後合併症に有意差はなかった．高齢者大腸癌におけるロボット支援手術は，非高齢者と比較し術後合併症は同等であり，安全に施行可能であった．

　Minimally invasive approaches including robot-assisted platforms have spread worldwide, however, the benefit and the risk for elderly patients are unclear. Patients with colorectal cancer who had robotic surgery were divided into two groups according to their age : elderly patients above the age of 80（group O : n＝56）and younger patients（group Y : n＝131）. Perioperative outcomes were compared between the two groups. The patients in group O had more comorbidity and large tumor size than in group Y. Patients with rectal cancer in group O had more permanent stoma than in group Y（p＝0.012）. The post operative hospital stay in group O with rectal cancer was longer than in group Y（10 days vs 7 days, p＝0.001）. There was no significant difference in the operative time, blood loss and the post operative complication rate between the two groups. Thus, robotic surgery for elderly colorectal cancer patients can be performed safely.