Robotic Colorectal Cancer in the Elderly

Colorectal cancer (CRC) is among the most common malignancies in Western countries. It is the second most commonly diagnosed cancer in women and the third in men, with 1,340,000 new diagnoses worldwide. In Italy, around 45,000 new cases are diagnosed each year, likely related to the increased life expectancy, since aging plays a significant causative role. Minimally invasive surgery is widely accepted as a safe, feasible and oncologically adequate treatment for CRC. Laparoscopic surgery offers favorable short-term results, a good procedure tolerance, a low conversion rate and postoperative complication rate, with a significant shortening of the postoperative stay. All these benefits also apply to the older population. The robotic technique is considered the evolution of conventional laparoscopic surgery. Few randomized clinical trials have compared the results of robotic versus laparoscopic surgery and the effects of the robotic approach in elderly patients. Nonetheless, published results support robotic surgery for CRC treatment in the elderly, as it is as feasible and safe as laparoscopic surgery, with favorable reports and similar oncological outcomes. However, an increased operating time is widely observed. The aim of this chapter is to evaluate whether old age alone should be one of the exclusion criteria for robotic surgery in CRC.