Browsing by Author "Trastulli, Stefano"

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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.