Minimally Invasive Distal Pancreatectomy for Cancer: Short-Term Oncologic Outcomes in 1733 Patients

2015 ◽  
Vol 39 (10) ◽  
pp. 2564-2572 ◽  
Author(s):  
Mohamed Abdelgadir Adam ◽  
Kingshuk Choudhury ◽  
Paolo Goffredo ◽  
Shelby D. Reed ◽  
Dan Blazer ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Pancreatectomy ◽  
Oncologic Outcomes ◽  
Short Term

Minimally Invasive Surgery of Rectal Cancer: Current Evidence and Options

2012 ◽  
pp. 214-218 ◽  
Author(s):  
Atthaphorn Trakarnsanga ◽  
Martin R. Weiser
Keyword(s):  
Rectal Cancer ◽  
Colon Cancer ◽  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Oncologic Outcomes ◽  
Current Status ◽  
Current Evidence ◽  
Short Term ◽  
Invasive Approach

Overview: Minimally invasive surgery (MIS) of colorectal cancer has become more popular in the past two decades. Laparoscopic colectomy has been accepted as an alternative standard approach in colon cancer, with comparable oncologic outcomes and several better short-term outcomes compared to open surgery. Unlike the treatment for colon cancer, however, the minimally invasive approach in rectal cancer has not been established. In this article, we summarize the current status of MIS for rectal cancer and explore the various technical options.

Short-Term Outcomes After Spleen-Preserving Minimally Invasive Distal Pancreatectomy With or Without Preservation of Splenic Vessels

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Maarten Korrel ◽  
Sanne Lof ◽  
Bilal Al Sarireh ◽  
Bergthor Björnsson ◽  
Ugo Boggi ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Distal Pancreatectomy ◽  
Short Term ◽  
Spleen Preserving ◽  
Splenic Vessels

The Impact of Conversion to Laparotomy in Rectal Cancer

2020 ◽  
Vol 86 (7) ◽  
pp. 811-818
Author(s):  
Salvatore A. Parascandola ◽  
Salini Hota ◽  
Mayou Martin T. Tampo ◽  
Andrew D. Sparks ◽  
Vincent Obias
Keyword(s):  
Rectal Cancer ◽  
Minimally Invasive ◽  
Large Population ◽  
Oncologic Outcomes ◽  
Minimally Invasive Approach ◽  
Short Term ◽  
Population Database ◽  
Invasive Approach ◽  
Positive Margins ◽  
The Impact

Background Data regarding the effect of conversion from minimally invasive surgery (MIS) to laparotomy in rectal cancer is limited. This study examines the impact of conversion from laparoscopic or robotic-assisted techniques to open resection on oncologic outcomes in a large population database. Methods The National Cancer Database from 2010 to 2016 was reviewed for all cases of invasive adenocarcinoma of the rectum or rectosigmoid junction managed surgically. Patients were divided into 3 cohorts by approach: laparoscopic/robotic (MIS), converted proctectomy (CP), and open proctectomy (OP). Kaplan–Meier estimation was used for unadjusted survival analysis, followed by adjusted multivariable Cox-Proportional Hazards regression. Secondary outcomes were analyzed by multivariable logistic regression. Results The inclusion criteria identified 57 574 patients cases of adenocarcinoma of the rectum managed surgically. Of these patients, 23 579 (41.0%) underwent MIS, 3591 (6.2%) CP, and 30 404 (52.8%) OP. Five-year overall survival was greater in the MIS (70.4%) versus CP and OP (64.4% and 61.4%). No differences were detected for positive margins, 30-day, or 90-day mortality between CP and OP. MIS and CP approaches were significantly associated with increased odds of 12 or more regional lymph nodes examined and decreased overall mortality hazard compared with OP (all respective significant P < .05). Discussion While similar odds of positive margins and short-term mortality is seen in patients whose procedure converts to laparotomy compared with planned laparotomy, both short-term and long-term oncologic benefit is seen in those who undergo a minimally invasive approach. Thus, a minimally invasive approach should be attempted for patients with rectal cancer.

P123 ROBOT ASSISTED MINIMALLY INVASIVE ESOPHAGECTOMY (RAMIE4) WITH INTRATHORACIC ANASTOMOSIS: PROMISING RESULTS AND LESSONS LEARNED IN 100 PATIENTS

2019 ◽  
Vol 32 (Supplement_2) ◽  
Author(s):  
E Tagkalos ◽  
der Sluis P C van ◽  
E Hadzijusufovic ◽  
B Babic ◽  
E Uzun ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Postoperative Complications ◽  
Minimally Invasive ◽  
Minimally Invasive Esophagectomy ◽  
Case Series ◽  
Oncologic Outcomes ◽  
Robot Assisted ◽  
Short Term ◽  
Intrathoracic Anastomosis ◽  
Invasive Esophagectomy

Abstract Aim The aim of this study was to describe postoperative complications and short-term oncologic outcomes for RAMIE4 with intrathoracic anastomosis for esophageal cancer within our case series of 100 consecutive patients. Background & Methods Robot assisted minimally-invasive esophagectomy (RAMIE) with intrathoracic anastomosis is gaining popularity as a treatment for esophageal cancer. In this study, we present the results of 100 RAMIE procedures using the da Vinci Xi robotic system (RAMIE4). The aim of this study was to describe postoperative complications and short-term oncologic outcomes for RAMIE4 within our case series of 100 consecutive patients. Between January 2017 and February 2019, data of 100 consecutive patients with esophageal carcinoma undergoing modified Ivor-Lewis esophagectomy were prospectively collected. All operations were performed by the same surgeon using an identical intrathoracic anastomotic reconstruction technique with the same perioperative management and pain control regimen. Intra-operatively and post operatively complications were graded according to definitions stated by the Esophagectomy Complications Consensus Group (ECCG). Results Mean duration of the surgical procedure was 416 min (± 80). In total, 70 patients (70%) had an uncomplicated operative procedure and postoperative recovery. Pulmonary complications were most common and were observed in 17 patients (17 %). Anastomotic leakage was observed in 8 patients (8%). Median ICU stay was 1 day and median overall postoperative hospital stay was 11 days. 30 day mortality was 1%. A R0 resection was reached in 92% of patients with a median number of 29 dissected lymph nodes. Conclusion RAMIE4 with intrathoracic anastomosis for esophageal cancer or cancer located in the esophagus was technically feasible and safe. Postoperative complications and short term oncologic results were comparable to the highest international standards nowadays. These results could only be obtained due to a structured RAMIE training pathway. The superiority of RAMIE compared to conventional minimally invasive esophagus is currently investigated in multiple randomized controlled trials. Results of these trials will define the role for RAMIE for patients with esophageal cancer in the future.

Robotic-Assisted versus Laparoscopic Distal Pancreatectomy: The Results of a Case-Matched Analysis from a Tertiary Care Center

2019 ◽  
Vol 37 (3) ◽  
pp. 229-239 ◽  
Author(s):  
Marco Vito Marino ◽  
Antonello Mirabella ◽  
Marcos Gomez Ruiz ◽  
Andrzej Lech Komorowski
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Distal Pancreatectomy ◽  
Laparoscopic Distal Pancreatectomy ◽  
Oncologic Outcomes ◽  
Robotic Group ◽  
Spleen Preservation ◽  
Robotic Assisted ◽  
Estimated Blood Loss ◽  
Preservation Rate

Background: Laparoscopic distal pancreatectomy (LDP) has been adopted relatively slowly despite the benefits of minimally invasive approach. The robotic approach can overcome the limitations of LDP, thus increasing the acceptance of minimally invasive distal pancreatectomy. Methods: We performed a 1:1 retrospective case-matched comparison among 2 groups of 35 patients who underwent robotic-assisted distal pancreatectomy (RDP) or LDP from August 2014 to April 2017. Results: The operative time was similar in both groups (230 RDP vs. 205 LDP min, p = 0.382). The robotic group had a lower estimated blood loss (95 vs. 275 mL, p = 0.035). The spleen preservation rate was higher in the RDP group (100 vs. 66.7%, p = 0.027), while the conversion rate to open surgery was higher in the laparoscopic group (14.3 vs. 2.9%, p = 0.048). The overall complication rate was lower in the robotic group (25.7 vs. 37.1%, p = 0.044). There was no statistically significant difference in oncologic outcomes between the groups in terms of R0 resection rate (100% RDP vs. 85% LDP, p = 0.233) and number of harvested lymph nodes (14.4 RDP vs. 10.8 LDP, p = 0.678). Conclusions: The RDP showed a lower estimated blood loss, conversion, and morbidity rate. It offered a higher spleen preservation rate in comparison to LDP while maintaining comparable oncologic outcomes.

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