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Minimally invasive surgery for gastric cancer: A comparison between robotic, laparoscopic and open surgery

World Journal of Gastroenterology 2017年第13期23卷 2376-2384页

作者： Amilcare Parisi Daniel Reim Felice borghi Ninh T Nguyen Feng Qi Andrea Coratti Fabio Cianchi Maurizio Cesari Francesca Bazzocchi Orhan Alimoglu Johan Gagnière Graziano Pernazza Simone D'Imporzano Yan-Bing Zhou Juan-Santiago Azagra Olivier Facy Steven T Brower Zhi-Wei Jiang Lu Zang Arda Isik Alessandro Gemini Stefano Trastulli Alexander Novotny Alessandra Marano Tong Liu Mario Annecchiarico Benedetta Badii giacomo Arcuri Andrea Avanzolini Metin Leblebici Denis Pezet Shou-Gen Cao Martine Goergen Shu Zhang Giorgio Palazzini Vito D'Andrea Jacopo Desiderio Department of Digestive Surgery St.Mary's HospitalUniversity of Perugia Klinik und Poliklinik fuer Chirurgie Klinikum Rechts der IsarTechnical University Munich Department of Surgery General and Oncologic Surgery UnitSanta Croce e Carle Hospital Department of Surgery Division of Gastrointestinal SurgeryUniversity of CaliforniaIrvine Medical Center Gastrointestinal Surgery Tianjin Medical University General Hospital Division of Oncological and Robotic Surgery Department of OncologyCareggi University Hospital Unit of general and endocrine surgery Center of oncologic minimally invasive surgery(COMIS)Careggi University Hospital Department of General Surgery Hospital of Cittàdi CastelloUSL1 Umbria Department of General Surgery Division of GeneralGastroenterologic and Minimally Invasive SurgeryG.B.Morgagni Hospital Department of General Surgery School of MedicineIstanbul Medeniyet University Department of Digestive and Hepatobiliary Surgery Estaing University Hospital Department of Surgery Robotic General Surgery UnitSan Giovanni Addolorata Hospital Esophageal Surgery Unit Tuscany Regional Referral Center for the Diagnosis and Treatment of Esophageal DiseaseMedical University of Pisa Department of General Surgery The Affiliated Hospital of Qingdao University Unitédes Maladies de l'Appareil Digestif et Endocrine Centre Hospitalier de Luxembourg Service de Chirurgie Digestive et Cancérologique CHU Bocage Department of Surgical Oncology and HPB Surgery Englewood Hospital and Medical Center Department of General Surgery Jinling HospitalMedical SchoolNanjing University Department of Surgery Ruijin HospitalShanghai Jiaotong UniversitySchool of Medicine Department of General Surgery Erzincan UniversitySchool of Medicine Department of Surgical Science “La Sapienza”University Department of Digestive Surgery St.Mary's Hospital of Terni-University of Perugia

AIM To investigate the role of minimally invasive surgery for gastric cancer and determine surgical, clinical, and oncological outcomes.METHODS This is a propensity score-matched case-control study, comparing three treatment arms: robotic gastrectomy(RG), laparoscopic gastrectomy(LG), open gastrectomy(OG). Data collection started after sharing a specific study protocol. Data were recorded through a tailored and protected web-based system. Primary outcomes: harvested lymph nodes, estimated blood loss, hospital stay, complications rate. Among the secondary outcomes, there are: operative time, R0 resections, POD of mobilization, POD of starting liquid diet and soft solid diet. The analysis includes the evaluation of type and grade of postoperative complications. Detailed information of anastomotic leakages is also provided.RESULTS The present analysis was carried out of 1026 gastrectomies. To guarantee homogenous distribution of cases, patients in the RG, LG and OG groups were 1:1:2 matched using a propensity score analysis with a caliper = 0.2. The successful matching resulted in a total sample of 604 patients(RG = 151; LG = 151; OG = 302). The three groups showed no differences in all baseline patients characteristics, type of surgery(P = 0.42) and stage of the disease(P = 0.16). Intraoperative blood loss was significantly lower in the LG(95.93 ± 119.22) and RG(117.91 ± 68.11) groups compared to the OG(127.26 ± 79.50, P = 0.002). The mean number of retrieved lymph nodes was similar between the RG(27.78 ± 11.45), LG(24.58 ± 13.56) and OG(25.82 ± 12.07) approach. A benefit in favor of the minimally invasive approaches was found in the length of hospital stay(P < 0.0001). A similar complications rate was found(P = 0.13). The leakage rate was not different(P = 0.78) between groups.CONCLUSION Laparoscopic and robotic surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recovery.

关键词： Gastric cancer Gastrectomy Minimally invasive surgery Robotic Robot-assisted Laparoscopy

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The enhanced X-ray Timing and Polarimetry mission—eXTP

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Science China(Physics,Mechanics & Astronomy) 2019年第2期62卷 3-27页

作者： ShuangNan Zhang Andrea Santangelo Marco Feroci YuPeng Xu FangJun Lu Yong Chen Hua Feng Shu Zhang Sφren Brandt Margarita Hernanz Luca Baldini Enrico Bozzo Riccardo Campana Alessandra De Rosa YongWei Dong Yuri Evangelista Vladimir Karas Norbert Meidinger Aline Meuris Kirpal Nandra Teng Pan Giovanni Pareschi Piotr Orleanski QiuShi Huang Stephane Schanne Giorgia Sironi Daniele Spiga Jiri Svoboda Gianpiero Tagliaferri Christoph Tenzer Andrea Vacchi Silvia Zane Dave Walton ZhanShan Wang Berend Winter Xin Wu Jean J.M.in't Zand Mahdi Ahangarianabhari Giovanni Ambrosi Filippo Ambrosino Marco Barbera Stefano Basso Jörg Bayer Ronaldo Bellazzini Pierluigi Bellutti Bruna Bertucci Giuseppe Bertuccio Giacomo Borghi XueLei Cao Franck Cadoux Francesco Ceraudo TianXiang Chen Yu Peng Chen Jerome Chevenez Marta Civitani Wei Cui WeiWei Cui Thomas Dauser Ettore Del Monte Sergio Di Cosimo Sebastian Diebold Victor Doroshenko Michal Dovciak YuanYuan Du Lorenzo Ducci QingMei Fan Yannick Favre Fabio Fuschino JoséLuis Ga'lvez Min Gao MingYu Ge Olivier Gevin Marco Grassi QuanYing Gu YuDong Gu DaWei Han Bin Hong Wei Hu Long Ji ShuMei Jia WeiChun Jiang Thomas Kennedy Ingo Kreykenbohm Irfan Kuvvetli Claudio Labanti Luca Latronico Gang Li MaoShun Li Xian Li Wei Li ZhengWei Li Olivier Limousin HongWei Liu XiaoJing Liu Bo Lu Tao Luo Daniele Macera Piero Malcovati Adrian Martindale Malgorzata Michalska Bin Meng Massimo Minuti Alfredo Morbidini Fabio Muleri Stephane Paltani Emanuele Perinati Antonino Picciotto Claudio Piemonte JinLu Qu Alexandre Rachevski Irina Rashevskaya Jerome Rodriguez Thomas Schanz ZhengXiang Shen LiZhi Sheng JiangBo Song LiMing Song Carmelo Sgro Liang Sun Ying Tan Phil Uttley Bo Wang DianLong Wang GuoFeng Wang Juan Wang LangPing Wang YuSa Wang Anna L.Watts XiangYang Wen Jörn Wilms ShaoLin Xiong JiaWei Yang Sheng Yang YanJi Yang Nian Yu WenDa Zhang Gianluigi Zampa Nicola Zampa Andrzej A.Zdziarski AiMei Zhang ChengMo Zhang Fan Zhang Long Zhang Tong Zhang Yi Zhang XiaoLi Zhang ZiLiang Zhang BaoSheng Zhao ShiJie Zheng Yu Peng Zhou Key Laboratory for Particle Astrophysics Institute of High Energy PhysicsChinese Academy of Sciences Institut für Astronomie und Astrophysik Eberhard Karls Universität INAF-Istituto di Astrofisica e Planetologia Spaziali INFN-Roma Tor Vergata Via della Ricerca Scientifica 1 Department of Engineering Physics and Center for Astrophysics Tsinghua University DTU Building 327DK-2800 Kongens Institute of Space Sciences 08193 Cerdanyola del Valles Institut d’Estudis Espacials de Catalunya Sezione di Pisa Istituto Nazionale di Fisica NucleareLargo Bruno Pontecorvo3 Department of Astronomy University of Genevachemin d’Ecogia 16 Osservatorio di Astrofisica e Scienza Dello Spazio di Bologna Istituto Nazionale di Astofisica Astronomical Institute Czech Academy of Sciences Max Planck Institute for Extraterrestrial Physics Giessenbachstr.1 CEA Paris-Saclay/IRFU Beijing Institute of Spacecraft System Engineering CAST Osservatorio Astronomico di Brera Istituto Nazionale di Astofisica Space Research Center Polish Academy of Sciences Key Laboratory of Advanced Material Microstructure of Education Ministry of China Institute of Precision Optical EngineeringSchool of Physics Science and EngineeringTongji University Department of Physics and Center for Astrophysics Tsinghua University Universita’degli Studi di Udine Via delle Scienze 206 Mullard Space Science Laboratory University College London Department of Nuclear and Particle Physics University of Geneva SRON Netherlands Institute for Space Research Politecnico di Milano Sezione di Perugia Istituto Nazionale di Fisica Nucleare Dipartimento di Fisica e Chimica Fondazione Bruno Kessler Dr.Karl Remeis-Observatory and Erlangen Centre for Astroparticle Physics Universität Erlangen-Nürnberg University of Pavia Department of ElectronicsInformation and Biomedical Engineering and INFN Pavia Sezione di Torino Istituto Nazionale di Fisica NucleareVia Pietro Giuria1 Department of Physics and Astronomy University of Leicester Sezione di Trieste Istituto Nazionale di Fisica Nucleare

In this paper we present the enhanced X-ray Timing and Polarimetry mission—eXTP. eXTP is a space science mission designed to study fundamental physics under extreme conditions of density, gravity and magnetism. The mission aims at determining the equation of state of matter at supra-nuclear density, measuring effects of QED, and understanding the dynamics of matter in strong-field gravity. In addition to investigating fundamental physics, eXTP will be a very powerful observatory for astrophysics that will provide observations of unprecedented quality on a variety of galactic and extragalactic objects. In particular, its wide field monitoring capabilities will be highly instrumental to detect the electro-magnetic counterparts of gravitational wave sources.The paper provides a detailed description of:(1) the technological and technical aspects, and the expected performance of the instruments of the scientific payload;(2) the elements and functions of the mission, from the spacecraft to the ground segment.

关键词： X-ray instrumentation X-ray polarimetry X-ray timing space mission:eXTP

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