Cancer Minimally Invasive Surgery

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (20 October 2023) | Viewed by 11179

Special Issue Editors

Special Issue Information

Dear Colleagues,

The current evidence suggests a beneficial impact of minimally invasive (laparoscopic or robotic-assisted) cancer surgery (i.e. gastrointestinal, gynecologic, thoracic, and genitourinary) on the outcomes of surgery and quality of life. There have been many technological advances in the past half century, which have led to the development of minimally invasive procedures that can reduce the negative consequences of radical surgery.  Nowadays, radical resections using laparoscopic and robotic surgical techniques rarely lead to major morbidity and mortality. In general, the short-term advantages of laparoscopic procedures, compared to open procedures, may include less postoperative pain, a smaller incision, earlier ambulation and return to work, a lower complication rate (i.e., bleeding), and shorter time of hospitalization. We invite research article submissions that will improve our knowledge on these topics. This Special Issue will publish original research and review articles.

Dr. Marco Vacante
Prof. Dr. Antonio Biondi
Guest Editors

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Keywords

  • laparoscopic surgery
  • robotic surgery
  • quality of life
  • colorectal cancer
  • gastrointestinal cancer
  • gynecologic cancer
  • tho-racic cancer
  • genitourinary cancer

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Published Papers (5 papers)

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Research

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10 pages, 866 KiB  
Article
Surgical Outcomes of Video-Assisted versus Open Pneumonectomy for Lung Cancer: A Real-World Study
by Jizhuang Luo, Chunyu Ji, Alessio Campisi, Tangbing Chen, Walter Weder and Wentao Fang
Cancers 2022, 14(22), 5683; https://doi.org/10.3390/cancers14225683 - 19 Nov 2022
Cited by 1 | Viewed by 1166
Abstract
Background: The safety, feasibility and potential benefits of Video-assisted thoracoscopic surgery (VATS) pneumonectomy remain to be investigated. Methods: Patients receiving VATS or Open pneumonectomy during the study period were included to compare surgical outcomes. Propensity-score matched (PSM) analysis was performed to eliminate potential [...] Read more.
Background: The safety, feasibility and potential benefits of Video-assisted thoracoscopic surgery (VATS) pneumonectomy remain to be investigated. Methods: Patients receiving VATS or Open pneumonectomy during the study period were included to compare surgical outcomes. Propensity-score matched (PSM) analysis was performed to eliminate potential biases. Results: From 2013 to 2020, 583 consecutive patients receiving either VATS (105, 18%) or Open (478, 82%) pneumonectomy were included. Conversion from VATS to open was found in 20 patients (19.0%). The conversion patients had similar rates of major complications and perioperative mortality compared with the Open group. After PSM, 203 patients were included. No significant differences were observed in major complications and perioperative mortality between the two groups. For patients with stage pT2 tumors, the major complication rate in the VATS group was significantly lower than in the Open group (7.6% vs. 20.6%, p = 0.042). Compared with left pneumonectomy, the incidence of bronchopleural fistula (BPF) was significantly higher in right pneumonectomy for both VATS (0 vs. 16.7%, p = 0.005) and Open (0.7% vs. 6.5%, p = 0.002) approaches. Conclusions: Perioperative results of VATS pneumonectomy are non-inferior to those of the Open approach. Conversion to open surgery does not compromise perioperative outcomes. Patients with lower pT stage tumors who need pneumonectomy may benefit from VATS. Full article
(This article belongs to the Special Issue Cancer Minimally Invasive Surgery)
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15 pages, 638 KiB  
Article
Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study
by Ingmar Wolff, Martin Burchardt, Christian Gilfrich, Julia Peter, Martin Baunacke, Christian Thomas, Johannes Huber, Rolf Gillitzer, Danijel Sikic, Christian Fiebig, Julie Steinestel, Paola Schifano, Niklas Löbig, Christian Bolenz, Florian A. Distler, Clemens Huettenbrink, Maximilian Janssen, David Schilling, Bara Barakat, Nina N. Harke, Christian Fuhrmann, Andreas Manseck, Robert Wagenhoffer, Ekkehard Geist, Lisa Blair, Jesco Pfitzenmaier, Bettina Reinhardt, Bernd Hoschke, Maximilian Burger, Johannes Bründl, Marco J. Schnabel and Matthias Mayadd Show full author list remove Hide full author list
Cancers 2022, 14(21), 5356; https://doi.org/10.3390/cancers14215356 - 30 Oct 2022
Cited by 8 | Viewed by 2036
Abstract
Patient’s regret (PatR) concerning the choice of therapy represents a crucial endpoint for treatment evaluation after radical prostatectomy (RP) for prostate cancer (PCA). This study aims to compare PatR following robot-assisted (RARP) and open surgical approach (ORP). A survey comprising perioperative-functional criteria was [...] Read more.
Patient’s regret (PatR) concerning the choice of therapy represents a crucial endpoint for treatment evaluation after radical prostatectomy (RP) for prostate cancer (PCA). This study aims to compare PatR following robot-assisted (RARP) and open surgical approach (ORP). A survey comprising perioperative-functional criteria was sent to 1000 patients in 20 German centers at a median of 15 months after RP. Surgery-related items were collected from participating centers. To calculate PatR differences between approaches, a multivariate regressive base model (MVBM) was established incorporating surgical approach and demographic, center-specific, and tumor-specific criteria not primarily affected by surgical approach. An extended model (MVEM) was further adjusted by variables potentially affected by surgical approach. PatR was based on five validated questions ranging 0–100 (cutoff >15 defined as critical PatR). The response rate was 75.0%. After exclusion of patients with laparoscopic RP or stage M1b/c, the study cohort comprised 277/365 ORP/RARP patients. ORP/RARP patients had a median PatR of 15/10 (p < 0.001) and 46.2%/28.1% had a PatR >15, respectively (p < 0.001). Based on the MVBM, RARP patients showed PatR >15 relative 46.8% less frequently (p < 0.001). Consensual decision making regarding surgical approach independently reduced PatR. With the MVEM, the independent impact of both surgical approach and of consensual decision making was confirmed. This study involving centers of different care levels showed significantly lower PatR following RARP. Full article
(This article belongs to the Special Issue Cancer Minimally Invasive Surgery)
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14 pages, 1313 KiB  
Article
Does Vaginal Cuff Creation and Avoidance of a Uterine Manipulator Improve the Prognosis of Total Laparoscopic Radical Hysterectomy for Early Cervical Cancer? A Retrospective Multicenter Study
by Eiji Kondo, Kenta Yoshida, Michiko Kubo-Kaneda, Masafumi Nii, Kota Okamoto, Shoichi Magawa, Ryo Nimua, Asumi Okumura, Toshiharu Okugawa, Takaharu Yamawaki, Kenji Nagao, Kouichi Yoshimura, Naoki Watashige, Kenji Yanoh and Tomoaki Ikeda
Cancers 2022, 14(18), 4389; https://doi.org/10.3390/cancers14184389 - 9 Sep 2022
Cited by 4 | Viewed by 3193
Abstract
Our goal was to compare the treatment outcomes of open-abdominal radical hysterectomy (O-RH) and total laparoscopic hysterectomy (TLRH) with vaginal cuff creation and without using a uterine manipulator in stage IB1-B2 (tumor size < 4 cm) cervical cancer cases. In this retrospective multicenter [...] Read more.
Our goal was to compare the treatment outcomes of open-abdominal radical hysterectomy (O-RH) and total laparoscopic hysterectomy (TLRH) with vaginal cuff creation and without using a uterine manipulator in stage IB1-B2 (tumor size < 4 cm) cervical cancer cases. In this retrospective multicenter analysis, 94 cervical cancer stage IB1-B2 patients who underwent O-RH or TLRH in six hospitals in Japan between September 2016 and July 2020 were included; 36 patients underwent TLRH. Propensity score matching was performed because the tumor diameter was large, and positive cases of lymph node metastases were included in the O-RH group due to selection bias. The primary endpoint was progression-free survival (PFS) and recurrence sites of TLRH and O-RH. PFS and OS (overall survival) were not significant in both the TLRH (n = 27) and O-RH (n = 27) groups; none required conversion to laparotomy. The maximum tumor size was <2 and ≥2 cm in 12 (44.4%) and 15 (55.6%) patients, respectively, in both groups. Reportedly, the TLRH group had lesser bleeding than the O-RH group (p < 0.001). Median follow-up was 33.5 (2–65) and 41.5 (6–75) months in the TLRH and O-RH groups, respectively. PFS and OS were not significantly different between the two groups (TLRH: 92.6%, O-RH: 92.6%; log-rank p = 0.985 and 97.2%, 100%; p = 0.317, respectively). The prognosis of early cervical cancer was not significantly different between TLRH and O-RH. Tumor spillage was prevented by creating a vaginal cuff and avoiding the use of a uterine manipulator. Therefore, TLRH might be considered efficient. Full article
(This article belongs to the Special Issue Cancer Minimally Invasive Surgery)
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15 pages, 2200 KiB  
Article
Transanal Total Mesorectal Excision (TaTME) versus Laparoscopic Total Mesorectal Excision for Lower Rectal Cancer: A Propensity Score-Matched Analysis
by Yueh-Chen Lin, Ya-Ting Kuo, Jeng-Fu You, Yih-Jong Chern, Yu-Jen Hsu, Yen-Lin Yu, Jy-Ming Chiang, Chien-Yuh Yeh, Pao-Shiu Hsieh and Chun-Kai Liao
Cancers 2022, 14(17), 4098; https://doi.org/10.3390/cancers14174098 - 24 Aug 2022
Cited by 4 | Viewed by 2037
Abstract
Studies have reported positive short-term and histopathological results of transanal total mesorectal excision (TaTME) for mid-low rectal cancer. The long-term oncological outcomes are diverse, and concerns regarding the high local recurrence (LR) rate of TaTME have recently increased. We retrospectively analyzed 298 consecutive [...] Read more.
Studies have reported positive short-term and histopathological results of transanal total mesorectal excision (TaTME) for mid-low rectal cancer. The long-term oncological outcomes are diverse, and concerns regarding the high local recurrence (LR) rate of TaTME have recently increased. We retrospectively analyzed 298 consecutive patients who underwent Laparoscopic TME (LapTME) or TaTME between January 2015 and December 2019. Propensity score-matching (PSM) was performed with patients matched for demographics and stage. After PSM, 63 patients were included in each group. The TaTME group had a longer mean operative time (394 vs. 333 min, p < 0.001). The blood loss, diverting stoma rate, and conversion rate were similar. Postoperatively, TaTME and LapTME had compatible complications, recovery, and hospital stay. A similar specimen quality was detected in both groups. After a mean follow-up period of 41–47 months, TaTME had less LR than LapTME (9.5% vs. 23.8%, p = 0.031). The 3-year overall survival was 80.3% in the TaTME group and 73.6% in the LapTME group (p = 0.331). The 3-year disease-free survival (DFS) rate was 72.0% in the TaTME group and 56.6% in the LapTME group (p = 0.038). In conclusion, better DFS and fewer LR events were observed after TaTME; thus, TaTME can be considered a safe and feasible approach in patients with low rectal cancer. Full article
(This article belongs to the Special Issue Cancer Minimally Invasive Surgery)
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Review

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15 pages, 512 KiB  
Review
Surgical Tolerability and Frailty in Elderly Patients Undergoing Robot-Assisted Radical Prostatectomy: A Narrative Review
by Yuta Yamada, Satoru Taguchi and Haruki Kume
Cancers 2022, 14(20), 5061; https://doi.org/10.3390/cancers14205061 - 16 Oct 2022
Cited by 6 | Viewed by 1718
Abstract
Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an [...] Read more.
Robot-assisted radical prostatectomy (RARP) has now become the gold standard treatment for localized prostate cancer. There are multiple elements in decision making for the treatment of prostate cancer. One of the important elements is life expectancy, which the current guidelines recommend as an indicator for choosing treatment options. However, determination of life expectancy can be complicated and difficult in some cases. In addition, surgical tolerability is also an important issue. Since frailty may be a major concern, it may be logical to use geriatric assessment tools to discriminate ‘surgically fit’ patients from unfit patients. Landmark studies show two valid models such as the phenotype model and the cumulative deficit model that allow for the diagnosis of frailty. Many studies have also developed geriatric screening tools such as VES-13 and G8. These tools may have the potential to directly sort out unfit patients for surgery preoperatively. Full article
(This article belongs to the Special Issue Cancer Minimally Invasive Surgery)
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