ROBOTIC RIGHT COLECTOMY IN A ELDERLY PATIENT DUE TO A CECUM ADENOCARCIONOMS ma_epstein@hotmail.com

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ROBOTIC RIGHT COLECTOMY IN A ELDERLY PATIENT DUE TO A CECUM ADENOCARCIONOMS

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Brazil

Video

The global population is aging, and with it, the prevalence of colorectal cancer (CRC) is increasing. Individuals aged ≥80 years represent a unique and growing subset of CRC patients. Minimally invasive surgery (MIS), particularly robotic-assisted colorectal surgery (RACS), has gained attention for its potential benefits in this demographic. RACS provides three-dimensional (3D) vision, wristed instrumentation motion scaling, tremor elimination, and improved ergonomics.

A 92-year-old female with a medical history of arterial hypertension, dyslipidemia, obesity (BMI 40kg/m2), and pulmonary. She required red blood cell transfusion to maintain hemoglobin levels around 8 g/dL. Colonoscopy revealed a bleeding cecal mass with invasion of the ileocecal valve. Biopsy confirmed adenocarcinoma. Computed tomography showed a cecal tumor approximately 7.8 cm in diameter, without evidence of distant metastasis. A robotic approach was proposed and informed consent obtained.

Right colectomy was performed with 12 mmHg pneumoperitoneum. Operative time was 60 minutes with 30 mL blood loss. One unit of blood was transfused. No intraoperative complications occurred. Recovery was uneventful and the patient was discharged on postoperative day 11. Pathology revealed a moderate adenocarcinoma of the Cecum 7.8cm in size with free margins. Stage T4aN1c and a total of 25 lymph nodes were removed

Early results from comparative studies show that RACS is safe and feasible in the elderly and it potentially confers the benefit of lower conversion, earlier return of gut function and shorter length of stay with comparable oncological outcomes. As such, age alone should not be a strict exclusion criterion for RACS.

https://vimeo.com/1098776188/4645eee033?share=copy