Publications by authors named "Coratti A"
Purpose: To assess the association between neoadjuvant therapy and overall survival (OS) in patients with left-sided resectable pancreatic cancer (RPC) compared to upfront surgery.
Background: Left-sided pancreatic cancer is associated with worse OS compared to right-sided pancreatic cancer. Although neoadjuvant therapy is currently seen as not effective in patients with RPC, current randomized trials included mostly patients with right-sided RPC.
Background: Minimally invasive distal pancreatectomy offers recognised benefits over open surgery. Robotic surgery, with its shorter learning curve and technical advancements, presents a promising alternative to laparoscopy in managing pancreatic diseases.
Methods: This study enrolled consecutive patients undergoing distal pancreatectomy between January 2013 and May 2022.
Objective: To validate the ISGPS complexity grading system for minimally invasive pancreaticoduodenectomy (MIPD).
Background: Although concerns about patient safety persist, MIPD is gaining popularity. The ISGPS recently introduced a difficulty grading system to improve patient selection by aligning procedural complexity with surgeon and center expertise.
Laparoscopic cholecystectomy (LC) is the gold standard for the treatment of symptomatic gallstones, acute cholecystitis, and acute gallstone pancreatitis. In recent years, the development and diffusion of robotic surgery have provided surgeons with the opportunity to apply this innovative approach to cholecystectomy, yielding interesting results. However, as with any new surgical technique, robotic cholecystectomy (RC) has met with skepticism within the surgical community.
View Article and Find Full Text PDFBackground: Although originally described as an open procedure, the application in the setting of minimally invasive surgery of the Pauli technique for parastomal hernia repair is gaining interest among surgeons owing to encouraging early results. We aimed at combining and analyzing the results of minimally invasive Pauli repair by assessing the available evidence.
Methods: A literature search in Pubmed, Embase, and Web of Science was undertaken to include all articles reporting on minimally invasive repair of parastomal hernias using the Pauli technique.
Aim: Ensuring an adequate distal resection margin (DRM) is a key factor in achieving the gold standard in surgical treatment for rectal surgery. The aim of this article is to describe our surgical technique and the usefulness of intraoperative ultrasonography (IOUS) for evaluating the DRM during robotic rectal surgery (RRS).
Method: Prospective data on five consecutive patients with rectal cancer who underwent RRS between January 2023 and December 2023 were collected.
Background: The double-stapled technique is the most common method of colorectal anastomosis in minimally invasive surgery. Several modifications to the conventional technique have been described to reduce the intersection between the stapled lines, as the resulting lateral dog-ears are considered possible risk factors for anastomotic leakage.
Objective: This study aimed to analyze the outcomes of patients receiving conventional versus modified stapled colorectal anastomosis after minimally invasive surgery.
Background: Although minimally invasive distal pancreatectomy (MIDP) is considered a standard approach it still presents a non-negligible rate of conversion to open that is mainly related to some difficulty factors, as obesity. The aim of this study is to analyze the preoperative factors associated with conversion in obese patients with MIDP.
Methods: In this multicenter study, all obese patients who underwent MIDP at 18 international expert centers were included.
Article Synopsis
- The study focused on the perioperative outcomes of pancreatic cancer surgeries during the COVID-19 pandemic, comparing data from 2019 and 2020.
- Researchers analyzed 1815 patients, finding no significant difference in cancer stages between the two years, but noted a decrease in neoadjuvant chemotherapy use and an increase in minimally invasive procedures in 2020.
- Despite some changes in treatment protocols and a rise in medical complications during surgery in 2020, the overall outcome for patients undergoing surgery for pancreatic cancer remained largely unaffected.
Article Synopsis
- * Minimally invasive techniques, including robotic surgery, are increasingly used for CP, yet it's unclear if robotic methods provide benefits over traditional techniques.
- * Current research on robotic CP is limited mostly to small case studies, and further investigation is needed to determine the best minimally invasive approach for this complex procedure.
Article Synopsis
- - The study compares the outcomes of robot-assisted and laparoscopic pancreatoduodenectomy across 50 European centers, focusing on major morbidity and mortality rates among patients from 2009 to 2020.
- - The results show no significant differences in major morbidity and 30-day mortality rates between the two surgical methods, but robot-assisted surgery had lower conversion rates and better lymph node retrieval.
- - Laparoscopic pancreatoduodenectomy had advantages like shorter operation times and lower rates of postoperative pancreatic complications, suggesting it may be the preferable approach in certain aspects.
Background: Central pancreatectomy (CP) is a parenchymal-sparing technique indicated for the resection of selected lesions of the neck or proximal body of the pancreas. The risk of postoperative complications is theoretically doubled because the surgeon has to manage two cut surfaces of the pancreas. The video shows a fully robotic CP to treat a 62-year-old male patient with a mixed-type intraductal papillary mucinous neoplasm (IPMN) of the pancreatic neck, using ultrasound (US) and Wirsung endoscopic evaluation to guide the pancreatic resection and ensure optimal resection margins.
View Article and Find Full Text PDFBackground: The aim of the present study is to compare outcomes of the robotic hand-sewn, linear- and circular-stapled techniques performed to create an intrathoracic esophagogastric anastomosis in patients who underwent Ivor-Lewis esophagectomy.
Methods: Patients who underwent a planned Ivor-Lewis esophagectomy were retrospectively analysed from prospectively maintained databases. Only patients who underwent a robotic thoracic approach with the creation of an intrathoracic esophagogastric anastomosis were included in the study.
Article Synopsis
- The REDISCOVER consensus conference focused on creating guidelines for the perioperative care of patients with borderline-resectable and locally advanced pancreatic ductal adenocarcinoma (PDAC).
- Using a structured methodology and expert consensus, the conference developed 34 recommendations on various aspects of surgical care, patient selection, and management of pancreatic cancer.
- Despite the low evidence quality for most recommendations, participants highlighted the importance of establishing an international registry to enhance understanding and care for this patient group.
Background: Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.
View Article and Find Full Text PDFObjective: To gain insight into the global practice of robot-assisted minimally invasive gastrectomy (RAMIG) and evaluate perioperative outcomes using an international registry.
Background: The techniques and perioperative outcomes of RAMIG for gastric cancer vary substantially in the literature.
Methods: Prospectively registered RAMIG cases for gastric cancer (≥10 per center) were extracted from 25 centers in Europe, Asia, and South-America.
Article Synopsis
- Robotic distal pancreatectomy (RDP) shows better short-term outcomes than laparoscopic distal pancreatectomy (LDP) in obese patients with a BMI of 30 or higher, including lower complication rates and less blood loss.
- The study included 446 obese patients over a 10-year span, focusing on surgery effectiveness and treatment comparisons at 18 expert centers.
- RDP was found to have a lower conversion rate to open surgery and achieved better spleen preservation compared to LDP, highlighting its advantages for surgical interventions in this patient group.
Background: Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC).
Methods: A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma) (01/2015-12/2021).
Article Synopsis
- The study aimed to create a standardized definition of intersphincteric resection (ISR) for very low-lying rectal cancers by reaching a consensus among international experts in the field.
- A modified Delphi method involving three rounds of questionnaires was used, with a total of 29 experts participating and achieving high agreement on 36 key statements related to ISR.
- The study resulted in clear definitions of ISR and related surgical procedures, established specific criteria for when to perform ISR, and created a flowchart and assessment protocol for surgical outcomes.
Background: Comparative 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 Design: Data of patients undergoing D2-OG or RG for gastric cancer were retrieved from the international IMIGASTRIC prospective database and compared.
This retrospective analysis of the prospective IGOMIPS registry reports on 1191 minimally invasive pancreatic resections (MIPR) performed in Italy between 2019 and 2022, including 668 distal pancreatectomies (DP) (55.7%), 435 pancreatoduodenectomies (PD) (36.3%), 44 total pancreatectomies (3.
View Article and Find Full Text PDFThe advantages of using the robotic platform may not be clearly evident in left colectomies, where the surgeon operates in an "open field" and does not routinely require intraoperative suturing. Current evidences are based on limited cohorts reporting conflicting outcomes regarding robotic left colectomies (RLC). The aim of this study is to report a bi-centric experience with robotic left colectomy in order to help in defining the role of the robotic approach for these procedures.
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