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

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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 *** 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 *** 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 surgery can be safely performed and proposed as possible alternative to open surgery. The main highlighted benefit is a faster postoperative functional recov

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

minimally invasive surgery in gastric cancer

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World Journal of Gastroenterology 2014年第39期20卷 14132-14141页

作者： Sang-Yong Son Hyung-Ho Kim Department of surgery Seoul National University Bundang Hospital Seongnam 463-707 South Korea

minimally invasive surgery for gastric cancer has rapidly gained popularity due to the early detection of early gastric cancer. As advances in instruments and the accumulation of laparoscopic experience increase, laparoscopic techniques are being used for less invasive but highly technical procedures. Recent evidence suggests that the short- and long-term outcomes of minimally invasive surgery for early gastric cancer and advanced gastric cancer are comparable to those of conventional open surgery. However, these results should be confirmed by large-scale multicenter prospective randomized controlled clinical trials.

关键词： Gastric cancer minimally invasive surgery Laparoscopic gastrectomy

minimally invasive surgery vs laparotomy in patients with colon cancer residing in high-altitude areas

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World Journal of Clinical Cases 2021年第35期9卷 10919-10926页

作者： Duo-Ji Suo Lang Yang-Zhen Ci Ren Zha-Xi Bian Ba Department of General surgery People’s Hospital of Tibet Autonomous RegionLasa 850000Tibet Autonomous RegionChina Department of Internal Medicine The Tibet Autonomous Region Centers for Disease Control and PreventionLasa 850000Tibet Autonomous RegionChina

BACKGROUND Colon cancer is associated with a higher incidence among residents in highaltitude *** environment at high altitudes inhibits the phagocytic and oxygen-dependent killing function of phagocytes,thereby increasing the inflammatory factors,inhibiting the body’s innate immunity and increasing the risk of colon *** To examine the effect of minimally invasive surgery vs laparotomy in patients with colon cancer residing in high-altitude *** Ninety-two patients with colon cancer in our hospital from January 2019 to February 2021 were selected and divided into the minimally invasive surgery and laparotomy groups using the random number table method,with 46 patients in each *** invasive surgery was performed in the minimally invasive group and laparotomy in the laparotomy *** conditions,inflammatory index pre-and post-surgery,immune function index and complication probability were *** Operative duration was significantly longer and intraoperative blood loss and recovery time of gastrointestinal function were significantly less(all Pminimally invasive group than in the laparotomy *** number of lymph nodes dissected was not significantly *** surgery,there were no significant differences in serum C-reactive protein,interleukin-6 and tumor necrosis factor-αlevels between the groups,whereas after surgery,the levels were significantly higher in the minimally invasive group(26.98±6.91 mg/L,146.38±11.23 ng/mL and 83.51±8.69 pg/mL vs 41.15±8.39 mg/L,186.79±15.36 ng/mL and 110.65±12.84 pg/mL,respectively,Psurgery,there were no significant differences in CD3+,CD4+and CD4+/CD8+levels between the groups,whereas after surgery,the levels decreased in both groups,being significantly higher in the minimally invasive group(55.61%±4.39%,35.45%±3.67%and 1.30±0.35 vs 49.68%±5.33%,31.21%±3.25%and 1.13±0.30,respectively,P<0.05).Complication probability was significant

关键词： minimally invasive surgery Laparotomy High-altitude area Colon cancer Surgical trauma Immune dysfunction

Variable stiffness methods of flexible robots for minimally invasive surgery:A review

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Biomimetic Intelligence & Robotics 2024年第3期4卷 3-14页

作者： Botao Lin Shuang Song Jiaole Wang Harbin Institute of Technology(Shenzhen) Shenzhen 518055China

With high flexibility and slim body,flexible robots have been widely used in minimally invasive surgery because they can safely reach the lesion deep inside the human body through small incisions or natural ***,high stiffness of robot body is also required for transferring force and maintaining the motion *** meet these two contradictory requirements,various methods have been implemented to enable adjustable stiffness for flexible surgical *** this review,we first summarize the anatomic constraints of common natural tracts of human body to provide a guidance for the design of variable stiffness flexible *** then,the variable stiffness methods have been categorized based on their basic principles of varying the *** the end,two variable stiffness methods with great potential and the moving strategy of variable stiffness flexible robots are discussed.

关键词： minimally invasive surgery Continuum robot Variable stiffness

Association of Satellite Sign with Postoperative Rebleeding in Patients Undergoing Stereotactic minimally invasive surgery for Hypertensive Intracerebral Haemorrhage

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Current Medical Science 2021年第3期41卷 565-571页

作者： Ajith Bemardin Raj Li-fei LIAN Feng XU Guo LI Shan-shan HUANG Qi-ming LIANG Kai LU Jian-ling ZHAO Fu-rong WANG Department of Neurology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery(MIS)for hypertensive intracerebral haemorrhage(ICH),and little is known about the relationship between satellite sign on computed tomography(CT)scans and postoperative rebleeding after *** study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic *** retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following *** rebleeding occurred in 14 of 65(21.5%)patients with the satellite sign on baseline CT,and in 5 of the 40(12.5%)patients without the satellite *** diiTerence was statistically *** and negative values of the satellite sign for predicting postoperative rebleeding were 21.5%and 87.5%,*** logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative *** conclusion,the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.

关键词： intracerebral haemorrhage minimally invasive surgery satellite sign computed tomography postoperative rebleeding

Complete mesocolic excision and central vascular ligation in colorectal cancer in the era of minimally invasive surgery

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World Journal of Clinical Cases 2021年第25期9卷 7297-7305页

作者： Marzia Franceschilli Sara Di Carlo Danilo Vinci Bruno Sensi Leandro Siragusa Vittoria Bellato Roberto Caronna Piero Rossi Giuseppe Cavallaro Andrea Guida Simone Sibio Department of surgery Minimally Invasive UnitTor Vergata University of RomeRome 00133Italy Department of Surgical Sciences Unit of Pancreatic and Biliary SurgerySapienza University of RomeRome 00161Italy Department of surgery P Valdoni Unit of Oncologic and Minimally Invasive SurgerySapienza University of RomeRome 00161Italy

Since the 19th century,appropriate lymphadenectomy has been considered a cornerstone of oncologic surgery and one of the most important prognostic *** approach can be applied to any surgery for gastrointestinal *** surgery for colon and rectal cancer,an adequate portion of the mesentery is removed together with the segment of bowel affected by the *** adequate number of lymph nodes to be removed is standardized and reported by several *** is mandatory to determine the appropriate extent of lymphadenectomy and to balance its oncological benefits with the increased morbidity associated with its execution in cancer *** review focuses on the concept of“complete mesenteric excision(CME)with central vascular ligation(CVL),”a radical lymphadenectomy for colorectal cancer that has gained increasing interest in recent *** aim of this study was to evaluate the evolution of this approach over the years,its potential oncologic benefits and potential risks,and the improvements offered by laparoscopic *** advantages of CME are improved local-relapse rates due to complete removal of the intact mesocolic fascia and improved distance recurrence rates due to ligation of vessels at their origin(CVL)which guarantees removal of a larger number of lymph *** development and worldwide diffusion of laparoscopic techniques minimized postoperative trauma in oncologic surgery,providing the same oncologic results as open *** has been widely applied to colorectal cancer surgery;however,CME entails a technical complexity that can limit its wide minimally-invasive application. This review analyzesresults of these procedures in terms of oncological outcomes, technical feasibilityand complexity, especially within the context of minimally invasive surgery.

关键词： Complete mesenteric excision Central vascular ligation Colorectal cancer Lymphadenectomy Laparoscopy minimally invasive surgery

Prognostic factors of minimally invasive surgery for gastric cancer: Does robotic gastrectomy bring oncological benefit?

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World Journal of Gastroenterology 2021年第39期27卷 6659-6672页

作者： Masaya Nakauchi Koichi Suda Susumu Shibasaki Kenichi Nakamura Shinichi Kadoya Kenji Kikuchi Kazuki Inaba Ichiro Uyama Department of Gastroenterological surgery Fujita Health UniversityToyoake 470-1192AichiJapan Department of Gastroenterological surgery Ishikawa Prefectural Central HospitalKanazawa 920-8535IshikawaJapan

BACKGROUND Gastric cancer is the third leading cause of cancer-related death worldwide and surgical resection remains the sole curative treatment for gastric *** invasive gastrectomy including laparoscopic and robotic approaches has been increasingly used in a few *** far,only a few reports have investigated the oncological outcomes following minimally invasive *** To determine the 5-year survival following minimally invasive gastrectomy for gastric cancer and identify prognostic *** This retrospective cohort study identified 939 patients who underwent gastrectomy for gastric cancer during the study *** excluding 125 patients with non-curative surgery(n=77),other synchronous cancer(n=2),remnant gastric cancer(n=25),insufficient physical function(n=13),and open gastrectomy(n=8),a total of 814 consecutive patients with primary gastric cancer who underwent minimally invasive R0 gastrectomy at our institution between 2009 and 2014 were retrospectively ***,5-year overall and recurrence-free survival were analyzed using the Kaplan–Meier method with the log-rank test and Cox regression analyses,while factors associated with survival were determined using multivariate *** Our analysis showed that age>65 years,American Society of Anesthesiologists(ASA)physical status 3,total or proximal gastrectomy,and pathological T4 and N positive status were independent predictors of both 5-year overall and recurrencefree ***,the included patients had a 5-year overall and recurrence-free survival of 80.3%and 78.2%,*** the 814 patients,157(19.3%)underwent robotic gastrectomy,while 308(37.2%)were diagnosed with pathological stage II or III ***,our findings showed that robotic gastrectomy was an independent positive predictor for recurrence-free survival in patients with pathological stage II/III[hazard ratio:0.56(0.33-0.96),P=0.035].Comparison of recurrence-fre

关键词： Laparoscopy Gastric cancer minimally invasive surgery Prognostic factor Stomach neoplasms

Re-appraisal and consideration of minimally invasive surgery in colorectal cancer

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Gastroenterology Report 2017年第1期5卷 1-10,I0001页

作者： Mahmoud Abu Gazala Steven D.Wexner Department of Colorectal surgery Cleveland Clinic FloridaWestonFLUSA

Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative *** the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known *** surgery has been shown to be equal or superior to open *** boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and *** paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.

关键词： colon cancer rectal cancer minimally invasive surgery laparoscopy robotic surgery transanal total mesorectal excision natural-orifice specimen extraction

Role of minimally invasive surgery for rectal cancer

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World Journal of Gastroenterology 2020年第30期26卷 4394-4414页

作者： Kurt A Melstrom Andreas M Kaiser Division of Colorectal surgery Department of SurgeryCity of Hope National Medical CenterDuarteCA 91010-3000United States

Rectal cancer is one of the most common malignancies *** resection for rectal cancer usually requires a proctectomy with respective lymphadenectomy(total mesorectal excision).This has traditionally been performed transabdominally through an open *** the last thirty years,minimally invasive surgery platforms have rapidly evolved with the goal to accomplish the same quality rectal resection through a less invasive *** are currently three resective modalities that complement the traditional open operation:(1)Laparoscopic surgery;(2)Robotic surgery;and(3)Transanal total mesorectal *** addition,there are several platforms to carry out transluminal local excisions(without lymphadenectomy).Evidence on the various modalities is of mixed to moderate *** is unreasonable to expect a randomized comparison of all options in a single *** review aims at reviewing in detail the various techniques in regard to intra-/perioperative benchmarks,recovery and complications,oncological and functional outcomes.

关键词： Rectal cancer minimally invasive surgery Laparoscopic surgery Robotic surgery Transanal total mesorectal excision Transanal minimally invasive surgery