Publications by authors named "Giacopuzzi S"

Objectives: The aim of the study was to report the first cases of surgical staging for apparently early-stage endometrial cancer performed using the Versius® next-generation robotic surgical system (Cambridge Medical Robots [CMR] Surgical, Cambridge, UK).

Design: The study used a prospective case series. Participants/Materials: Women who underwent surgical staging, including total hysterectomy, bilateral adnexectomy, and sentinel lymph node (SLN) biopsy, for apparently early-stage endometrial cancer using the Versius® next-generation robotic surgical system (CMR Surgical, Cambridge, UK) were included.

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  • This study evaluates the effectiveness of Robot-assisted minimally invasive esophagectomy (RAMIE) for treating esophageal cancer at various centers globally, aiming to pinpoint areas for enhancement in surgical outcomes.
  • Over three time periods (2016-2023), data from 28 centers was analyzed, revealing improvements in textbook outcome rates, lymph node yields, and decreased hospital stays, particularly with McKeown procedures.
  • The results showed varying success rates in surgical outcomes and complications, with a noteworthy decrease in anastomotic leakage rates and hospital stays over time, highlighting advancements in surgical techniques.
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  • Various anastomotic and reconstruction techniques were assessed in patients undergoing minimally invasive total (miTG) and distal gastrectomy (miDG) to understand their impact on postoperative complications.
  • A study involving over 4,200 patients found that miTG had significantly higher rates of complications like anastomotic leakage and overall morbidity compared to miDG.
  • The findings suggest that miDG is preferable for patients needing surgery, while linear stapled techniques should be favored in miTG to minimize risks.*
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: Despite the strong declining trends in incidence and mortality over the last decades, gastric cancer (GC) is still burdened with high mortality, even in high-income countries. To improve GC prognosis, several guidelines have been increasingly published with indications about the most appropriate GC management. The Italian Society of Digestive System Pathology (SIPAD) and Gastric Cancer Italian Research Group (GIRCG) designed a survey for both surgeons and patients with the purpose of evaluating the degree of application and adherence to guidelines in GC management in Italy.

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Background: Management of mediastinal anastomotic leaks (MALs) after Ivor Lewis esophagectomy includes conservative, endoscopic, or surgical management. Endoscopic vacuum therapy (EVAC) is becoming a routine approach for MALs, although the outcomes have not been defined. This study aimed to describe the incidence, treatment, and outcomes of MALs in patients who underwent esophagectomy in 3 Italian high-volume centers that routinely use EVAC for MAL.

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Background: 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.

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Background: Guidelines on the treatment of oesophageal squamous cell carcinoma (SCC) recommend neoadjuvant chemoradiotherapy plus surgery or definitive chemoradiotherapy. The aim of this study was to evaluate the outcome of patients with a cCR after chemoradiotherapy who underwent active surveillance.

Methods: Patients with oesophageal SCC who were treated with chemoradiotherapy between January 2016 and June 2022 were identified from an institutional database.

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Approximately 10-12% of patients with oesophageal or gastric cancer (OGC) present with oligometastatic disease at diagnosis. It remains unclear if there is a role for radical surgery in these patients. We aimed to assess the outcomes of OGC patients who underwent simultaneous treatment for the primary tumour and synchronous liver metastases.

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The overall frequency of postoperative complications in patients with esophageal and gastric cancer diverges between studies. We evaluated the frequency and assessed the relationship between complications and demographic and clinical features. For this observational study, data were extracted from the ERAS Registry managed by the University of Verona, Italy.

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The optimal treatment for esophageal cancer in elderly patients is still debated and data on postoperative results are limited. This retrospective international study aims to clarify the impact of age on clinical and oncological outcomes after esophagectomy. All patients that underwent esophagectomy for cancer between 2007 and 2016 at two European high-volume Centers have been included in the study.

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  • Oncovascular surgery, which involves removing major blood vessels affected by cancer, is crucial for achieving complete removal of tumors in advanced ovarian cancer patients.
  • A review of patient cases at Verona University showed that five patients had successful major vascular resections, with all having preoperative identification of vascular involvement and obtaining R0 status (no visible cancer remaining).
  • The literature review found a total of 12 cases of major vessel resections in ovarian cancer, with a notable percentage experiencing postoperative complications, yet a majority remained disease-free at their last follow-up.
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Introduction: While enhanced recovery after surgery (ERAS) protocol demonstrated to improve outcomes after gastrectomy, some papers evidenced a detrimental effect on postoperative morbidity related to the "weekday effect." We aimed to understand whether the day of gastrectomy could affect postoperative outcomes and compliance with ERAS items.

Methods: We included all patients that underwent gastrectomy for cancer between January 2017 and September 2021.

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Background: This study evaluated the efficacy of pressurized intraperitoneal aerosol chemotherapy (PIPAC) with systemic chemotherapy as a bidirectional approach for gastric cancer (GC) patients with synchronous peritoneal metastases (SPM).

Methods: A retrospective analysis of a prospective PIPAC database was queried for patients who underwent a bidirectional approach between October 2019 and April 2022 at two high-volume GC surgery units in Italy (Verona and Siena). Surgical and oncological outcomes were analyzed.

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  • Trastuzumab combined with chemotherapy is the first-line treatment for patients with HER2+ advanced esophagogastric cancer, but many patients develop resistance to it.
  • A study investigated whether inhibiting Fibroblast Growth Factor Receptor (FGFR) 3 could be an effective second-line treatment for patients who no longer respond to trastuzumab.
  • Out of eight patients enrolled, the trial showed limited success: only one patient maintained stable disease after 12 weeks, leading to the trial's early termination, indicating that targeting FGFR may not be effective for unselected patients resistant to trastuzumab.
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Background: Robotic-assisted minimally invasive esophagectomy (RAMIE) combines the beneficial effects of minimally invasive surgery on postoperative complications, especially on pulmonary ones, with the safety of the anastomosis performed in open surgery. Moreover, RAMIE could allow a more accurate lymphadenectomy.

Methods: We reviewed our database to identify all patients with adenocarcinoma of the esophagus treated by Ivor-Lewis esophagectomy in the period January 2014 to June 2022.

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Introduction: RCTs support neoadjuvant chemoradiotherapy (nCRT) followed by surgery in locally advanced esophago-gastric junction (LA-EGJ) adenocarcinoma. However, RCTs are performed in highly controlled settings with limited representativeness of real-life patients (RLS). The aim of the study was to compare the outcomes in RLS and clinical trial settings.

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  • The Italian Research Group for Gastric Cancer (GIRCG) noted in 2013 that laparoscopic or robotic surgeries should primarily be used for early gastric cancer (EGC), with no further guidelines available at that time.
  • A recent study surveyed 46 out of 100 expert Italian upper gastrointestinal surgeons on their use of minimally invasive techniques for gastric cancer treatment, finding a similar preference for these methods in both early and advanced gastric cancer cases.
  • The results indicated that as the number of surgical procedures performed at a center increased, so did the likelihood of utilizing minimally invasive approaches, suggesting a shift in clinical practice beyond current national guidelines.
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Evidence against the use of prophylactic drain after gastrectomy are increasing and ERAS guidelines suggest the benefit of drain avoidance. Nevertheless, it is unclear whether this practice is still widespread. We conducted a survey among Italian surgeons through the Italian Gastric Cancer Research Group and the Polispecialistic Society of Young Surgeons, aiming to understand the current use of prophylactic drain.

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Background: Oncologic outcomes after laparoscopic gastrectomy for advanced gastric cancer in the West have been poorly investigated. The aim of the present study was to compare survival outcomes in patients undergoing curative-intent laparoscopic and open gastrectomy for advanced gastric cancer in several centres belonging to the Italian Research Group for Gastric Cancer.

Methods: Data of patients operated between 2015 and 2018 were retrospectively analysed.

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Gastrectomy for gastric cancer is still performed in Western countries with high morbidity and mortality. Post-operative complications are frequent, and effective diagnosis and treatment of complications is crucial to lower the mortality rates. In 2015, a project was launched by the EGCA with the aim of building an agreement on list and definitions of post-operative complications specific for gastrectomy.

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  • The iGreenGO Study is a national multicenter research project focusing on the use of near-infrared/indocyanine green (NIR/ICG) imaging technology during surgery for advanced gastric cancer (AGC).
  • It involves administering ICG injections to patients undergoing surgery and evaluates how this technology may change surgical practices, especially in terms of whether further dissection is needed.
  • The study aims to provide insights into the effectiveness of NIR/ICG in a large group of Western patients, potentially improving surgical outcomes in AGC treatment.
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Purpose: Quality of Life (QoL) after extensive head and neck resections is of paramount importance, especially after pharyngolaryngectomy or pharyngolaryngoesophagectomy where complex digestive tract reconstruction is required (with gastric pull-up or colon transposition). Tracheodigestive puncture (TDP) is the only vocal restoration option in this group of patients. The aim of this study is to evaluate postoperative complications, vocal outcomes, voice-related and swallowing-related QoL after secondary TDP in this cohort of patients.

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Optimal surgical treatment for Siewert type II esophagogastric junction adenocarcinoma is debated. The aim of this study was to compare transhiatal extended gastrectomy (TEG) and transthoracic esophagectomy (TTE). Patients with Siewert type II tumors who underwent a resection by TEG or TTE in two centers (Erasmus University Medical Center, Rotterdam, and University of Verona) between 2014 and 2019 were identified.

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