NCT03765411

Brief Summary

The objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly. A retrospective cross-sectional cohort study utilizing the Nationwide Inpatient Sample (NIS; 2006-2013) was performed.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
6,740

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Jan 2013

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

January 1, 2013

Completed
3 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 15, 2013

Completed
4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 15, 2017

Completed
1.6 years until next milestone

First Submitted

Initial submission to the registry

November 28, 2018

Completed
7 days until next milestone

First Posted

Study publicly available on registry

December 5, 2018

Completed
Last Updated

December 5, 2018

Status Verified

December 1, 2018

Enrollment Period

3 months

First QC Date

November 28, 2018

Last Update Submit

December 4, 2018

Conditions

Rectal Cancer

Outcome Measures

Primary Outcomes (1)

  • In-hospital Complications

    Complications to include mechanical wound, infections, urinary, pulmonary, gastrointestinal, cardiovascular, systemic, surgical, and any complication

    through study completion, an average of 5 days

Secondary Outcomes (3)

  • In-hospital mortality

    through study completion, an average of 5 days

  • Length of Stay

    through study completion, an average of 5 days

  • Costs and Charges

    through study completion, an average of 5 days

Study Arms (3)

Open Proctectomy Patients

Patients who underwent Proctectomy through an open approach

Procedure: Proctectomy

Laparoscopic Proctectomy Patients

Patients who underwent Proctectomy through a Laparoscopic approach

Procedure: Proctectomy

Robotic Proctectomy Patients

Patients who underwent Proctectomy through a Robotic approach

Procedure: Proctectomy

Interventions

ProctectomyPROCEDURE

Resection of the rectum

Laparoscopic Proctectomy PatientsOpen Proctectomy PatientsRobotic Proctectomy Patients

Eligibility Criteria

Age70 Years+
Sexall
Age GroupsOlder Adult (65+)
Sampling MethodProbability Sample
Study Population

Patients were eligible if they were 70 years old or greater, underwent proctectomy in an elective setting, and did not have an abdominoperioneal resection.

You may qualify if:

  • years of age or older
  • underwent proctectomy

You may not qualify if:

  • emergent admissions
  • abdominoperineal resections

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Tripler Army Medical Center

Honolulu, Hawaii, 96859, United States

Location

Related Publications (34)

  • Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2012 Oct;60(10):E1-E25. doi: 10.1111/j.1532-5415.2012.04188.x. Epub 2012 Sep 19. No abstract available.

    PMID: 22994865RESULT

  • Fielding LP, Phillips RK, Hittinger R. Factors influencing mortality after curative resection for large bowel cancer in elderly patients. Lancet. 1989 Mar 18;1(8638):595-7. doi: 10.1016/s0140-6736(89)91618-8.

    PMID: 2564119RESULT

  • Tan KY, Kawamura Y, Mizokami K, Sasaki J, Tsujinaka S, Maeda T, Konishi F. Colorectal surgery in octogenarian patients--outcomes and predictors of morbidity. Int J Colorectal Dis. 2009 Feb;24(2):185-9. doi: 10.1007/s00384-008-0615-9. Epub 2008 Dec 3.

    PMID: 19050901RESULT

  • Law WL, Chu KW, Tung PH. Laparoscopic colorectal resection: a safe option for elderly patients. J Am Coll Surg. 2002 Dec;195(6):768-73. doi: 10.1016/s1072-7515(02)01483-7.

    PMID: 12495308RESULT

  • Cheung HY, Chung CC, Fung JT, Wong JC, Yau KK, Li MK. Laparoscopic resection for colorectal cancer in octogenarians: results in a decade. Dis Colon Rectum. 2007 Nov;50(11):1905-10. doi: 10.1007/s10350-007-9070-x. Epub 2007 Sep 26.

    PMID: 17899275RESULT

  • Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM. Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum. 2000 Mar;43(3):326-32. doi: 10.1007/BF02258297.

    PMID: 10733113RESULT

  • Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C. Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum. 2005 Nov;48(11):2070-5. doi: 10.1007/s10350-005-0147-0.

    PMID: 16086219RESULT

  • Champagne BJ, Delaney CP. Laparoscopic approaches to rectal cancer. Clin Colon Rectal Surg. 2007 Aug;20(3):237-48. doi: 10.1055/s-2007-984868.

    PMID: 20011205RESULT

  • Jayne DG, Brown JM, Thorpe H, Walker J, Quirke P, Guillou PJ. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique. Br J Surg. 2005 Sep;92(9):1124-32. doi: 10.1002/bjs.4989.

    PMID: 15997446RESULT

  • van der Pas MH, Haglind E, Cuesta MA, Furst A, Lacy AM, Hop WC, Bonjer HJ; COlorectal cancer Laparoscopic or Open Resection II (COLOR II) Study Group. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013 Mar;14(3):210-8. doi: 10.1016/S1470-2045(13)70016-0. Epub 2013 Feb 6.

    PMID: 23395398RESULT

  • Park S, Kim NK. The Role of Robotic Surgery for Rectal Cancer: Overcoming Technical Challenges in Laparoscopic Surgery by Advanced Techniques. J Korean Med Sci. 2015 Jul;30(7):837-46. doi: 10.3346/jkms.2015.30.7.837. Epub 2015 Jun 10.

    PMID: 26130943RESULT

  • Baik SH, Kwon HY, Kim JS, Hur H, Sohn SK, Cho CH, Kim H. Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann Surg Oncol. 2009 Jun;16(6):1480-7. doi: 10.1245/s10434-009-0435-3. Epub 2009 Mar 17.

    PMID: 19290486RESULT

  • Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH. A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol. 2012 Aug;19(8):2485-93. doi: 10.1245/s10434-012-2262-1. Epub 2012 Mar 21.

    PMID: 22434245RESULT

  • D'Annibale A, Pernazza G, Monsellato I, Pende V, Lucandri G, Mazzocchi P, Alfano G. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer. Surg Endosc. 2013 Jun;27(6):1887-95. doi: 10.1007/s00464-012-2731-4. Epub 2013 Jan 5.

    PMID: 23292566RESULT

  • Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V. Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum. 2008 Mar;51(3):296-300. doi: 10.1007/s10350-007-9124-0. Epub 2008 Jan 15.

    PMID: 18197453RESULT

  • Jayne D, Pigazzi A, Marshall H, Croft J, Corrigan N, Copeland J, Quirke P, West N, Rautio T, Thomassen N, Tilney H, Gudgeon M, Bianchi PP, Edlin R, Hulme C, Brown J. Effect of Robotic-Assisted vs Conventional Laparoscopic Surgery on Risk of Conversion to Open Laparotomy Among Patients Undergoing Resection for Rectal Cancer: The ROLARR Randomized Clinical Trial. JAMA. 2017 Oct 24;318(16):1569-1580. doi: 10.1001/jama.2017.7219.

    PMID: 29067426RESULT

  • Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373-83. doi: 10.1016/0021-9681(87)90171-8.

    PMID: 3558716RESULT

  • Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data. Med Care. 1998 Jan;36(1):8-27. doi: 10.1097/00005650-199801000-00004.

    PMID: 9431328RESULT

  • Washington CW, Derdeyn CP, Dacey RG Jr, Dhar R, Zipfel GJ. Analysis of subarachnoid hemorrhage using the Nationwide Inpatient Sample: the NIS-SAH Severity Score and Outcome Measure. J Neurosurg. 2014 Aug;121(2):482-9. doi: 10.3171/2014.4.JNS131100. Epub 2014 Jun 20.

    PMID: 24949676RESULT

  • Singh JA, Kwoh CK, Boudreau RM, Lee GC, Ibrahim SA. Hospital volume and surgical outcomes after elective hip/knee arthroplasty: a risk-adjusted analysis of a large regional database. Arthritis Rheum. 2011 Aug;63(8):2531-9. doi: 10.1002/art.30390.

    PMID: 21656509RESULT

  • Schlussel AT, Lustik MB, Johnson EK, Maykel JA, Champagne BJ, Damle A, Ross HM, Steele SR. A nationwide assessment comparing nonelective open with minimally invasive complex colorectal procedures. Colorectal Dis. 2016 Mar;18(3):301-11. doi: 10.1111/codi.13113.

    PMID: 26362693RESULT

  • Damle A, Damle RN, Flahive JM, Schlussel AT, Davids JS, Sturrock PR, Maykel JA, Alavi K. Diffusion of technology: Trends in robotic-assisted colorectal surgery. Am J Surg. 2017 Nov;214(5):820-824. doi: 10.1016/j.amjsurg.2017.03.020. Epub 2017 Mar 21.

    PMID: 28347491RESULT

  • Lee MG, Chiu CC, Wang CC, Chang CN, Lee SH, Lee M, Hsu TC, Lee CC. Trends and Outcomes of Surgical Treatment for Colorectal Cancer between 2004 and 2012- an Analysis using National Inpatient Database. Sci Rep. 2017 May 17;7(1):2006. doi: 10.1038/s41598-017-02224-y.

    PMID: 28515452RESULT

  • Halabi WJ, Kang CY, Jafari MD, Nguyen VQ, Carmichael JC, Mills S, Stamos MJ, Pigazzi A. Robotic-assisted colorectal surgery in the United States: a nationwide analysis of trends and outcomes. World J Surg. 2013 Dec;37(12):2782-90. doi: 10.1007/s00268-013-2024-7.

    PMID: 23564216RESULT

  • Tam MS, Kaoutzanis C, Mullard AJ, Regenbogen SE, Franz MG, Hendren S, Krapohl G, Vandewarker JF, Lampman RM, Cleary RK. A population-based study comparing laparoscopic and robotic outcomes in colorectal surgery. Surg Endosc. 2016 Feb;30(2):455-463. doi: 10.1007/s00464-015-4218-6. Epub 2015 Apr 17.

    PMID: 25894448RESULT

  • Baek JH, Pastor C, Pigazzi A. Robotic and laparoscopic total mesorectal excision for rectal cancer: a case-matched study. Surg Endosc. 2011 Feb;25(2):521-5. doi: 10.1007/s00464-010-1204-x. Epub 2010 Jul 7.

    PMID: 20607559RESULT

  • Schlussel AT, Delaney CP, Maykel JA, Lustik MB, Nishtala M, Steele SR. A National Database Analysis Comparing the Nationwide Inpatient Sample and American College of Surgeons National Surgical Quality Improvement Program in Laparoscopic vs Open Colectomies: Inherent Variance May Impact Outcomes. Dis Colon Rectum. 2016 Sep;59(9):843-54. doi: 10.1097/DCR.0000000000000642.

    PMID: 27505113RESULT

  • Antoniou SA, Antoniou GA, Koch OO, Pointner R, Granderath FA. Laparoscopic colorectal surgery confers lower mortality in the elderly: a systematic review and meta-analysis of 66,483 patients. Surg Endosc. 2015 Feb;29(2):322-33. doi: 10.1007/s00464-014-3672-x. Epub 2014 Jul 2.

    PMID: 24986017RESULT

  • Seishima R, Okabayashi K, Hasegawa H, Tsuruta M, Shigeta K, Matsui S, Yamada T, Kitagawa Y. Is laparoscopic colorectal surgery beneficial for elderly patients? A systematic review and meta-analysis. J Gastrointest Surg. 2015 Apr;19(4):756-65. doi: 10.1007/s11605-015-2748-9. Epub 2015 Jan 24.

    PMID: 25617077RESULT

  • Park JS, Choi GS, Lim KH, Jang YS, Jun SH. Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol. 2010 Dec;17(12):3195-202. doi: 10.1245/s10434-010-1162-5. Epub 2010 Jun 30.

    PMID: 20589436RESULT

  • Keller DS, Senagore AJ, Lawrence JK, Champagne BJ, Delaney CP. Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection. Surg Endosc. 2014 Jan;28(1):212-21. doi: 10.1007/s00464-013-3163-5. Epub 2013 Aug 31.

    PMID: 23996335RESULT

  • Li Y, Wang S, Gao S, Yang C, Yang W, Guo S. Laparoscopic colorectal resection versus open colorectal resection in octogenarians: a systematic review and meta-analysis of safety and efficacy. Tech Coloproctol. 2016 Mar;20(3):153-62. doi: 10.1007/s10151-015-1419-x. Epub 2016 Jan 18.

    PMID: 26783029RESULT

  • Park JS, Choi GS, Lim KH, Jang YS, Jun SH. S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancer. Surg Endosc. 2011 Jan;25(1):240-8. doi: 10.1007/s00464-010-1166-z. Epub 2010 Jun 15.

    PMID: 20552367RESULT

  • Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP; STROCSS Group. The STROCSS statement: Strengthening the Reporting of Cohort Studies in Surgery. Int J Surg. 2017 Oct;46:198-202. doi: 10.1016/j.ijsu.2017.08.586. Epub 2017 Sep 7.

    PMID: 28890409RESULT

Related Links

MeSH Terms

Conditions

Rectal Neoplasms

Interventions

Proctectomy

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesIntestinal DiseasesRectal Diseases

Intervention Hierarchy (Ancestors)

Surgical Procedures, ColorectalDigestive System Surgical ProceduresSurgical Procedures, Operative

Study Design

Study Type
observational
Observational Model
CASE ONLY
Time Perspective
CROSS SECTIONAL
Target Duration
1 Year
Sponsor Type
FED
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
General Surgery Chief Resident Surgeon

Study Record Dates

First Submitted

November 28, 2018

First Posted

December 5, 2018

Study Start

January 1, 2013

Primary Completion

April 15, 2013

Study Completion

April 15, 2017

Last Updated

December 5, 2018

Record last verified: 2018-12

Locations

US(1)