Browsing by Author "Gonzalez, Paulina"

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    Laparoscopic Compared with Open D2 Gastrectomy on Perioperative and Long-Term, Stage-Stratified Oncological Outcomes for Gastric Cancer: A Propensity Score-Matched Analysis of the IMIGASTRIC Database
    (2021) Trastulli, Stefano; Desiderio, Jacopo; Lin, Jian-Xian; Reim, Daniel; Zheng, Chao-Hui; Borghi, Felice; Cianchi, Fabio; Norero, Enrique; Nguyen, Ninh T.; Qi, Feng; Coratti, Andrea; Cesari, Maurizio; Bazzocchi, Francesca; Alimoglu, Orhan; Brower, Steven T.; Pernazza, Graziano; D'Imporzano, Simone; Azagra, Juan-Santiago; Zhou, Yan-Bing; Cao, Shou-Gen; Garofoli, Eleonora; Mosillo, Claudia; Guerra, Francesco; Liu, Tong; Arcuri, Giacomo; Gonzalez, Paulina; Staderini, Fabio; Marano, Alessandra; Terrenato, Irene; D'Andrea, Vito; Bracarda, Sergio; Huang, Chang-Ming; Parisi, Amilcare
    Simple Summary:Gastric resection with D2 lymphadenectomy is considered the gold standard for the treatment of both advanced and early gastric cancer with lymph node metastasis. The performance of D2 lymphadenectomy is technically challenging and represents a key factor in improving patients' survival. For these reasons, the execution of gastrectomy with D2 lymphadenectomy using the traditional open surgical technique still represents the most widespread approach and, based on current international guidelines, the indication for laparoscopic surgery is limited to early gastric cancer that does not require a D2 lymphadenectomy. The present study aimed to investigate the use of laparoscopic versus open surgical approaches in performing gastrectomy with D2 lymphadenectomy for cancer in terms of intraoperative and postoperative outcomes and long-term survival. The study was conducted using the data collected in the International study group on Minimally Invasive surgery for Gastric Cancer (IMIGASTRIC) international database.
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    Open vs robotic gastrectomy with D2 lymphadenectomy: a propensity score-matched analysis on 1469 patients from the IMIGASTRIC prospective database
    (2023) Trastulli, Stefano; Desiderio, Jacopo; Lin, Jian-Xian; Reim, Daniel; Zheng, Chao-Hui; Borghi, Felice; Cianchi, Fabio; Norero, Enrique; Nguyen, Ninh T. T.; Qi, Feng; Coratti, Andrea; Cesari, Maurizio; Bazzocchi, Francesca; Alimoglu, Orhan; Brower, Steven T. T.; Pernazza, Graziano; D'Imporzano, Simone; Azagra, Juan-Santiago; Zhou, Yan-Bing; Cao, Shou-Gen; Guerra, Francesco; Liu, Tong; Arcuri, Giacomo; Gonzalez, Paulina; Staderini, Fabio; Marano, Alessandra; Di Nardo, Domenico; Parisi, Amilcare; Huang, Chang-Ming; Tebala, Giovanni Domenico
    BackgroundComparative data on D2-robotic gastrectomy (RG) vs D2-open gastrectomy (OG) are lacking in the Literature. Aim of this paper is to compare RG to OG with a focus on D2-lymphadenectomy.Study designData of patients undergoing D2-OG or RG for gastric cancer were retrieved from the international IMIGASTRIC prospective database and compared.ResultsA total of 1469 patients were selected for inclusion in the study. After 1:1 propensity score matching, a total of 580 patients were matched and included in the final analysis, 290 in each group, RG vs OG. RG had longer operation time (210 vs 330 min, p < 0.0001), reduced intraoperative blood loss (155 vs 119.7 ml, p < 0.0001), time to liquid diet (4.4 vs 3 days, p < 0.0001) and to peristalsis (2.4 vs 2 days, p < 0.0001), and length of postoperative stay (11 vs 8 days, p < 0.0001). Morbidity rate was higher in OG (24.1% vs 16.2%, p = 0.017).ConclusionRG significantly expedites recovery and reduces the risk of complications compared to OG. However, long-term survival is similar.
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    SURVIVAL AND PERIOPERATIVE MORBIDITY OF TOTALLY LAPAROSCOPIC VERSUS OPEN GASTRECTOMY FOR EARLY GASTRIC CANCER: ANALYSIS FROM A SINGLE LATIN AMERICAN CENTRE
    (2019) Norero, Enrique; Vargas, Catalina; Achurra, Pablo; Ceroni, Marco; Mejia, Ricardo; Martinez, Cristian; Munoz, Rodrigo; Gonzalez, Paulina; Calvo, Alfonso; Diaz, Alfonso
    Background: Laparoscopic gastrectomy has numerous perioperative advantages, but the long-term survival of patients after this procedure has been less studied. Aim: To compare survival, oncologic and perioperative outcomes between completely laparoscopic vs. open gastrectomy for early gastric cancer. Methods: This study was retrospective, and our main outcomes were the overall and disease-specific 5-year survival, lymph node count and RO resection rate. Our secondary outcome was postoperative morbidity. Results: Were included 116 patients (59% men, age 68 years, comorbidities 73%, BMI 25) who underwent 50 laparoscopic gastrectomies and 66 open gastrectomies. The demographic characteristics, tumour location, type of surgery, extent of lymph node dissection and stage did not significantly differ between groups. The overall complication rate was similar in both groups (40% vs. 28%, p=ns), and complications graded at least Clavien 2 (36% vs. 18%, p=0.03), respiratory (9% vs. 0%, p=0.03) and wound-abdominal wall complications (12% vs. 0%, p= 0.009) were significantly lower after laparoscopic gastrectomy. The lymph node count (21 vs. 23 nodes; p=ns) and RO resection rate (100% vs. 96%; p=ns) did not significantly differ between groups. The 5-year overall survival (84% vs. 87%, p=0.31) and disease-specific survival (93% vs. 98%, p=020) did not significantly differ between the laparoscopic and open gastrectomy groups. Conclusion: The results of this study support similar oncologic outcome and long-term survival for patients with early gastric cancer after laparoscopic gastrectomy and open gastrectomy. In addition, the laparoscopic approach is associated with less severe morbidity and a lower occurrence of respiratory and wound-abdominal wall complications.