eP729 - Conversion Rate Following Different Minimally Invasive Approaches in pT4 Right-Side Colon Adenocarcinoma: A Retrospective Database Analysis

Tuesday, June 4, 2024

8:30 AM – 8:35 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

ePoster Presenter(s)

Danielle L. Humphries, MD

Resident Physician
Central Michigan University
Central Michigan University College of Medicine
Saginaw, MI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

FP

Felipe Andres Pacheco, MD

Surgery Resident
Central Michigan University
Saginaw, Michigan, United States

Disclosure information not submitted.
Shravani Sripathi, MD

Resident
Central Michigan University Medical Education Partners - - Saginaw, MI
Central Michigan University Medical Education Partners
Saginaw, MI, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
CK

Charles A. Keane, n/a

Resident
Central Michigan University
Grosse pointe, Michigan, United States

Disclosure information not submitted.
SC

Stalin Canizares, n/a

Alumni
Universidad San Francisco de Quito
Boston, Massachusetts, United States

Disclosure information not submitted.
EL

Emmanuel Luciano, MD

Resident
Central Michigan University
Saginaw, Michigan, United States

Disclosure information not submitted.
OL

Olivia Lossia, md

Resident
CMU Health Education Partners
Saginaw, Michigan, United States

Disclosure information not submitted.

Senior Author(s)

wS

wael Solh, MD FASCRS

Section chief general surgery
CMU college of medicine
Saginaw, Michigan, United States

Disclosure information not submitted.

Purpose/Background: Minimally invasive surgery has become the standard in colon cancer resections as it is associated with decreased length of stay and faster recovery. Multiple studies have compared the outcomes of robotic versus laparoscopic surgery in right colon cancer showing conflicting results. There are not studies analyzing outcomes in patients with locally advanced right-sided colon cancer.Methods/Interventions: The National Cancer Database was reviewed for the period of 2010-2020. Patients who underwent right hemicolectomies for pT4 colon adenocarcinoma were analyzed. The surgical approaches were divided into laparoscopic and robotic. The main outcome was the conversion rate to an open surgery with the two different approaches. A logistic regression analysis was performed which included demographic variables and tumor characteristics.Results/Outcomes: 14985 patients were identified. Of those, 1350 underwent robotic surgery and 13635 underwent laparoscopic surgery. The conversion rate was 12.4% (167 cases) for the robotic group and 21.5% (2930 cases) in the laparoscopic group. On the logistic regression, the patients who underwent laparoscopic surgery were more likely to be converted to open (OR 1.974, p < 0.001). Metropolitan areas and private insurance were associated with a lower conversion rate.Conclusion/

Discussion: Minimally invasive surgery is preferred over open surgery for colon cancer resections. For patients with locally advanced tumors, there seems to be an advantage to robotic surgery with lower conversion rates when compared to laparoscopic surgery. A potential explanation may be related to the improved exposure and instrument articulation provided by the robotic platform. Further prospective data in this complex subset of patients should be obtained to further delineate the differences between robotic and laparoscopic surgery and the factors that result in conversion to open approaches.