Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
AI Summary:
The study found that robotic-assisted surgery (RAS) was associated with lower postoperative systemic inflammatory response (SIR), and a better postoperative complications profile.AI Topics:
Introduction: There is growing evidence that the use of robotic-assisted surgery (RAS) in colorectal cancer resections is associated with improved short-term outcomes when compared to laparoscopic surgery (LS) or open surgery (OS), possibly through a reduced systemic inflammatory response (SIR). Serum C-reactive protein (CRP) is a sensitive SIR biomarker and its utility in the early identification of post-operative complications has been validated in a variety of surgical procedures. There remains a paucity of studies characterising post-operative SIR in RAS.
Methods: Retrospective study of a prospectively collected database of consecutive patients undergoing OS, LS and RAS for left-sided and rectal cancer in a single high-volume unit. Patient and disease characteristics, post-operative CRP levels, and clinical outcomes were reviewed, and their relationships explored within binary logistic regression and propensity scores matched models.
Results: A total of 1031 patients were included (483 OS, 376 LS, and 172 RAS). RAS and LS were associated with lower CRP levels across the first 4 post-operative days (p < 0.001) as well as reduced complications and length of stay compared to OS in unadjusted analyses. In binary logistic regression models, RAS was independently associated with lower CRP levels at Day 3 post-operatively (OR 0.35, 95% CI 0.21-0.59, p < 0.001) and a reduction in the rate of all complications (OR 0.39, 95% CI 0.26-0.56, p < 0.001) and major complications (OR 0.5, 95% CI 0.26-0.95, p = 0.036). Within a propensity scores matched model comparing LS versus RAS specifically, RAS was associated with lower post-operative CRP levels in the first two post-operative days, a lower proportion of patients with a CRP ≥ 150 mg/L at Day 3 (20.9% versus 30.5%, p = 0.036) and a lower rate of all complications (34.7% versus 46.7%, p = 0.033).
Conclusions: The present observational study shows that an RAS approach was associated with lower postoperative SIR, and a better postoperative complications profile.
Ingham,, Abigail R.
Author
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listKong, Chia Yew
Author
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listWong, Tin-Ning
Author
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listMcSorley, Steven T.
Author
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Brown, Leo R. and Thomson, Georgina G. and Gardner, Ellen and Chien, Siobhan and McGovern, Josh and Dolan, Ross D. and McSorley, Stephen T. and Forshaw, Matthew J. and McMillan, Donald C. and Wigmore, Stephen J. and Crumley, AndrewB. and Skipworth, Richard J.E. (2024) Cachexia index for prognostication in surgical patients with locally advanced oesophageal or gastric cancer: multicentre cohort study. British Journal of Surgery, 111 (4): znae098. ISSN 0007-1323
See full publications listMcMillan, D.C.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listNicholson, Gary A.
Author
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listAlani, Ahmed
Author
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listMansouri, David
Author
Golder, Allan M. and Ferguson, Michael and McMillan, Paul and Mansouri, David and Horgan, Paul G. and Roxburgh, Campbell S. and Dolan, Ross D. and McGovern, Josh and McMillan, Donald (2024) CT-derived body composition and differential association with age, TNM stage and systemic inflammation in patients with colon cancer. Scientific Reports, 14: 15673. ISSN 2045-2322
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
Johnstone, Mark S. and McSorley, Steven T. and McMillan, Donald C. and Horgan, Paul G. and Mansouri, David (2024) The relationship between systemic inflammatory response, screen detection and outcome in colorectal cancer. Colorectal Disease, 26 (1). pp. 81-94. ISSN 1462-8910
See full publications listChong, David
Author
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listMackay, Graham J.
Author
Ingham, Abigail R. and McSorley, Stephen T. and McMillan, Donald C. and Chong, David and Mackay, Graham J. and Wrobel, Aleksandra and Kong, Chia Yew and Alani, Ahmed and Nicholson, Gary and Roxburgh, Campbell S.D. (2025) Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? Journal of Robotic Surgery, 19 (1): 98. ISSN 1863-2483
Ingham,, Abigail R. and Kong, Chia Yew and Wong, Tin-Ning and McSorley, Stephen T. and McMillan, Donald C. and Nicholson, Gary A. and Alani, Ahmed and Mansouri, David and Chong, David and Mackay, Graham J. and Roxburgh, Campbell S.D. (2024) Robotic-assisted surgery for left sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surgical Endoscopy. ISSN 0930-2794
See full publications listRoxburgh, Campbell S. D.
Author
Bradley, Nicholas A. and Walter, Amy and Sankey, Chiara and Wilson, Alasdair and Siddiqui, Tamim and Roxburgh, Campbell D. and McMillan, Donald C. and Guthrie, Graeme J.K. (2025) Longitudinal association between statins and changes in CT derived body composition in patients with abdominal aortic aneurysm. Journal of Cachexia, Sarcopenia and Muscle, 16 (2). ISSN 2190-5991
Thompson, Joshua J. and MacLeod, Nicholas and Will, Sarah and O'Rourke, Fraser and McGovern, Josh and Roxburgh, Campbell and Edwards, Joanne and Dolan, Ross D. and McMillan, Donald C. (2025) The prognostic value of a laboratory cachexia score (LCAS) defined by LDH, CRP and albumin in patients with advanced lung cancer. BMC Cancer, 25: 543. ISSN 1471-2407
Dolan, Ross D. and Pennel, Kathryn and Thompson, Joshua and McKenzie, Molly and Alexander, Peter and Richards, Colin and Black, Douglas and Abbass, Tanvir and Maka, Noori and McGovern, Josh and Roseweir, Antonia and McSorley, Stephen T. and Horgan, Paul G. and Roxburgh, Campbell and McMillan, Donald C. and Edwards, Joanne (2025) The relationship between tumour necrosis, systemic inflammation, body composition and survival in patients with colon cancer. BJC Reports, 3 (1): 7. ISSN 2731-9377
See full publications listAvailable under License Creative Commons Attribution.
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