Current and Future Directions in Gastric Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Gastroenterology & Hepatology".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 6134

Special Issue Editors


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Guest Editor
Department of Medical and Surgical Sciences, University of Bologna, 47121 Forlì, Italy
Interests: gastric cancer; surgical oncology; minimally invasive surgery; robotic surgery; laparoscopic surgery; early gastric cance; conversion surgery

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Co-Guest Editor
Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37129 Verona, Italy
Interests: gastric cancer; poorly cohesive carcinoma; signet ring cell; surgical oncology; minimally invasive surgery; multimodal therapies; molecular subtypes

Special Issue Information

Dear Colleagues,

The treatment of gastric cancer has been changing during the last 10 years. The multimodal approach is offering innovative treatment options with improved prognosis also in Stage IV patients. On the other hand, technological advances are promoting the diffusion of minimally invasive treatments, exploiting robotics, augmented reality, and artificial intelligence.

This Special Issue aims to explore the latest updates in the management of gastric cancer, focusing on the multimodal, molecular-based, and surgical treatment of these patients.

Dr. Leonardo Solaini
Dr. Maria Bencivenga
Guest Editors

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Keywords

  • robotic gastrectomy
  • laparoscopic gastrectomy
  • minimally invasive surgery
  • conversion surgery
  • chemotherapy
  • target therapy
  • stage IV gastric cancer
  • neoadjuvant treatments
  • peritoneal carcinomatosis
  • fluorescence guided surgery
  • artificial intelligence

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Published Papers (2 papers)

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16 pages, 2602 KiB  
Systematic Review
Gastrectomy with or without Complete Omentectomy for Advanced Gastric Cancer: A Meta-Analysis
by Maurizio Zizzo, Magda Zanelli, Francesca Sanguedolce, Andrea Palicelli, Stefano Ascani, Andrea Morini, David Tumiati, Federica Mereu, Antonia Lavinia Zuliani, Melissa Nardecchia, Francesca Gatto, Manuel Zanni and Alessandro Giunta
Medicina 2022, 58(9), 1241; https://doi.org/10.3390/medicina58091241 - 7 Sep 2022
Cited by 5 | Viewed by 2506
Abstract
Background and Objectives: Surgery remains the only possible curative treatment for advanced gastric cancer (AGC). Peritoneal metastases are estimated to occur in approximately 55–60% AGC patients. Greater omentum is the most common metastatic area in AGC. At present, omentectomy alone or bursectomy [...] Read more.
Background and Objectives: Surgery remains the only possible curative treatment for advanced gastric cancer (AGC). Peritoneal metastases are estimated to occur in approximately 55–60% AGC patients. Greater omentum is the most common metastatic area in AGC. At present, omentectomy alone or bursectomy are usually carried out during gastric cancer surgery. We performed a meta-analysis in order to evaluate long-term and short-term outcomes among AGC patients, who have undergone radical gastrectomy with or without complete omentectomy (CO). Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Meta-analysis was performed by use of RevMan (Computer program) Version 5.4. Results: The eight included studies covered an approximately 20 years long study period (2000–2018). Almost all included studies were retrospective ones and originated from Asian countries. Meta-analysis indicated gastrectomy without CO as significantly associated with longer 3-year (RR: 0.94, 95% CI: 0.90–0.98, p = 0.005) and 5-year overall survivals (OS) (RR: 0.93, 95% CI: 0.88–0.98, p = 0.007). Moreover, we found longer operative time (MD: 24.00, 95% CI: −0.45–48.45, p = 0.05) and higher estimated blood loss (MD: 194.76, 95% CI: 96.40–293.13, p = 0.0001) in CO group. Conclusions: Non-complete omentectomy (NCO) group had a statistically greater rate in 3-year and 5-year OSs than the CO group, while the CO group had significantly longer operative time and higher estimated blood loss than the NCO group. Further randomized, possibly multi-center trials may turn out of paramount importance in confirming our results. Full article
(This article belongs to the Special Issue Current and Future Directions in Gastric Surgery)
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24 pages, 5654 KiB  
Systematic Review
Robotic versus Laparoscopic Gastrectomy for Gastric Cancer: An Updated Systematic Review
by Maurizio Zizzo, Magda Zanelli, Francesca Sanguedolce, Federica Torricelli, Andrea Morini, David Tumiati, Federica Mereu, Antonia Lavinia Zuliani, Andrea Palicelli, Stefano Ascani and Alessandro Giunta
Medicina 2022, 58(6), 834; https://doi.org/10.3390/medicina58060834 - 20 Jun 2022
Cited by 9 | Viewed by 2855
Abstract
Background and Objectives: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-term outcomes. In [...] Read more.
Background and Objectives: Gastrectomy with D2 lymphadenectomy is the standard surgical treatment with curative intent for patients with gastric cancer (GC). Over the last three decades, surgeons have been increasingly adopting laparoscopic surgery for GC, due to its better short-term outcomes. In particular, laparoscopic gastrectomy (LG) has been routinely used for early gastric cancer (EGC) treatment. However, LG suffers from technical limitations and drawbacks, such as a two-dimensional surgical field of view, limited movement of laparoscopic tools, unavoidable physiological tremors and discomfort for operating surgeon. Therefore, robotic surgery has been developed to address such limitations. Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines in order to investigate the benefits and harms of robotic gastrectomy (RG) compared to the LG. PubMed/MEDLINE, Scopus, Cochrane Library (Cochrane Database of Systematic Re-views, Cochrane Central Register of Controlled Trials-CENTRAL) and Web of Science (Science and Social Science Citation Index) databases were used to search all related literature. Results: The 7 included meta-analyses covered an approximately 20 years-study period (2000–2020). Almost all studies included in the meta-analyses were retrospective ones and originated from Asian countries (China and Korea, in particular). Examined overall population ranged from 3176 to 17,712 patients. If compared to LG, RG showed both operative advantages (operative time, estimated blood loss, number of retrieved lymph nodes) and perioperative ones (time to first flatus, time to restart oral intake, length of hospitalization, overall complications, Clavien-Dindo (CD) ≥ III complications, pancreatic complications), in the absence of clear differences of oncological outcomes. However, costs of robotic approach appear significant. Conclusions: It is impossible to make strong recommendations, due to the statistical weakness of the included studies. Further randomized, possibly multicenter trials are strongly recommended, if we want to have our results confirmed. Full article
(This article belongs to the Special Issue Current and Future Directions in Gastric Surgery)
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