Full Robotic Gastrectomy with Extended (D2) Lymphadenectomy for Gastric Cancer: Surgical Technique and Preliminary Results
| Autor: | Graziano Pernazza, Gianna Sovernigo, Vito Pende, Emilio Morpurgo, Giorgio Lucandri, Paolo Mazzocchi, Annibale D’Annibale, Igor Monsellato, Tania Contardo |
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| Rok vydání: | 2011 |
| Předmět: |
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Laparoscopic surgery medicine.medical_specialty Databases Factual medicine.medical_treatment Blood Loss Surgical Pilot Projects Adenocarcinoma Disease-Free Survival Da Vinci Surgical System Gastrectomy Stomach Neoplasms medicine Humans Minimally Invasive Surgical Procedures Robotic surgery Laparoscopy Lymph node Aged medicine.diagnostic_test business.industry Cancer Robotics Middle Aged medicine.disease Surgery medicine.anatomical_structure Tissue and Organ Harvesting Lymph Node Excision Female Lymphadenectomy business Follow-Up Studies |
| Zdroj: | Journal of Surgical Research. 166:e113-e120 |
| ISSN: | 0022-4804 |
| DOI: | 10.1016/j.jss.2010.11.881 |
| Popis: | Background Widespread diffusion of minimally-invasive surgery for gastric cancer treatment is limited by the complexity of performing an extended D2-lymphadenectomy. This surgical step can be facilitated by using robot-assisted surgery. The aim of this study is to describe our technique and short-term results of a consecutive series of full robotic gastrectomies with D2-lymphadenectomy for gastric cancer, using the da Vinci Surgical System. Materials and Methods Between May 2004 and December 2009, we performed 24 consecutive full robot-assisted total and subtotal gastrectomies with extended D2-lymphadenectomy for histologically-proven gastric adenocarcinoma. Data referring to 11 robot-assisted total gastrectomies and 13 subtotal gastrectomies were collected in a database and analyzed. Results Median operative time was 267.50 min (255–305). Median intraoperative blood loss was 30 mL. Median number of harvested lymph nodes was 28 (23–34). Resection margins were negative in all cases. No conversions occurred. Surgery-related morbidity was 8%. Thirty-day mortality was 0%. Liquid diet started on postoperative d 5 (2–5). Median length of stay was 6 d (5–8). Conclusions Robot-assisted gastrectomy with D2-lymphadenectomy is a safe technique and allows achieving an adequate lymph node harvest and optimal R0-resection rates with low postoperative morbidity and the learning curve appears to be shorter than in laparoscopic surgery. Longer follow-up and randomized clinical trials are needed to define the role of robot-assistance in gastric cancer surgery. |
| Databáze: | OpenAIRE |
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