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Background: To some extent, robotic technique does offer certain benefits in rectal cancer surgery than laparoscopic one, while remains a topic of ongoing debate for rectal cancer patients who had undergone neoadjuvant chemoradiotherapy (NCRT)., Methods: Potential studies published until January 2024 were obtained from Web of Science, Cochrane Library, Embase and PubMed. Dichotomous and continuous variables were expressed as odds ratios (ORs) and weighted mean differences (WMDs) with 95% their confidence intervals (CIs), respectively. A random effects model was used if I2 statistic >50%, otherwise a fixed effects model., Results: Eleven studies involving 1079 patients were analyzed. The robotic-assisted group had an 0.4 cm shorter distance from anal verge (95% CI: -0.680 to -0.114, P=0.006) and 1.94 times higher complete total mesorectal excision (TME) rate (OR=1.936, 95% CI: 1.061 to 3.532, P=0.031). However, the operation time in the robotic-assisted group was 54 minutes longer (95% CI: 20.489 to 87.037, P=0.002) than laparoscopic group. In addition, the robotic-assisted group had a lower open conversion rate (OR=0.324, 95% CI: 0.129 to 0.816, P=0.017) and a shorter length of hospital stay (WMD=-1.127, 95% CI: -2.071 to -0.184, P=0.019)., Conclusion: Robot-assisted surgery offered several advantages over laparoscopic surgery for locally advanced mid-low rectal cancer following NCRT in terms of resection of lower tumours with improved TME completeness, lower open conversion rate and shorter hospital stay, despite longer operative time., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Accumulating evidence has confirmed the potential prognostic value of LVI in patients with cancers. This aim of the current study was to clarify the potential relationship between LVI and lymph node metastasis, establish predictive clinicopathologic prognostic factors for LVI and lymph node metastasis, and determine the prognostic significance of LVI for patients younger than 70 years with resected gastric cancer., Methods: Overall survival rates were calculated using Kaplan-Meier analysis. Differences in proportions of patients were tested with the χ 2 test. Univariate and multivariate analyses were applied to identify independent prognostic factors. Logistic regression analysis was employed to identify the risk factors predicting the presence of LVI and LN metastasis., Results: Univariate analysis led to the identification of tumor size, LVI and pN stage as factors significantly correlated with prognosis. Multivariate analysis demonstrated that tumor size, LVI, pN stage, and number of LNs retrieved are independent prognostic factors for the entire population. Logistic regression analysis proved that LVI and pT stage were significantly associated with LN metastasis., Conclusion: LVI is an independent prognostic factor predicting LN metastasis and a strongly independent predictor of survival for patients with resected gastric cancer. We recommend that LVI should be taken into account as an important adjuvant prognostic factor, specially for pN0 cases with inadequate LNs retrieved. And the maximum number of LNs possible should be retrieved for optimal staging, especially for patients with higher cT stage., (Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.)

Background: The aim of this study was to conduct a meta-analysis comparing the oncological, intraoperative and safety outcomes in sigmoid and rectal cancer surgery with and without preservation of the left colic artery (LCA)., Method: We searched Medline, Embase, China National Knowledge Infrastructure (CNKI), and PubMed databases for relevant articles published between 1962 and 2017. Randomized and non-randomized clinical trials were identified and included in the study. End-points evaluated included 5-year mortality, number of patients with retrieved positive metastatic lymph nodes (LN) at the root of inferior mesenteric artery (IMA), number of retrieved LNs, morbidity, mortality, recurrence, bowel obstruction, intraoperative blood loss, anastomotic leakage, operation time, surgical site infection and postoperative bleed. Meta-analysis was conducted using RevMan 5.3 software. The odds ratio (OR) with 95% confidence intervals (CI) was used to analyze dichotomous data., Results: Seventeen studies including 6247 patients were identified for the meta-analysis. Meta-analysis revealed that preserving the LCA was associated with reduced anastomotic leakage rate (OR, 0.78; 95% CI, 0.62-0.98; P = 0.03). There were no significant differences between the two groups with respect to the 5-year mortality, number of retrieved LNs, number of patients with retrieved positive metastatic LNs at the root of IMA, morbidity, mortality, recurrence, bowel obstruction, intraoperative blood loss, operation time, surgical site infection and postoperative bleed., Conclusion: In comparison with ligating the left colic artery, preserving the left colic artery seems to achieve comparable success with acceptable safety outcomes and we suggest to preserve the LCA in the sigmoid and rectal cancer surgeries. However, more multicenter randomized controlled trials are required to further evaluate the efficacy and safety of preserving the left colic artery in surgeries., (Copyright © 2018. Published by Elsevier Ltd.)

Background: To compare the efficacy and safety of endoscopic resection (ER) and radical gastrectomy (RG) for early gastric cancer (EGC) in Asia., Materials and Methods: We systematically searched relevant articles published before September 1, 2017. We evaluated the quality of the included non-randomized studies using the Newcastle-Ottawa Scale (NOS). Meta-analysis was carried out using RevMan 5.3 software. The odds ratio (OR) with 95% confidence intervals (CI) were used for the dichotomous data., Results: Fifteen retrospective studies were included in this analysis (3737 patients in the ER group and 4246 patients in RG group). No significant differences in the three-year survival rate (OR, 0.87; 95%CI, 0.50-1.53) and five-year survival rate (OR, 0.81; 95%CI, 0.58-1.13) between the ER and RG groups were observed. Although patients undergoing ER had a higher risk of recurrence (OR, 6.07; 95%CI 4.17-8.84) and the occurrence of metachronous cancer (OR, 8.35; 95%CI, 5.48-12.75), recurrent or metachronous gastric cancers following ER were successfully detected and removed using the endoscopic technique. Higher recurrence in the ER group may be associated with its lower en bloc resection rate (OR, 0.05; 95%CI, 0.02-0.14) and complete resection rate (OR, 0.03; 95%CI, 0.01-0.08). Importantly, although the three-year survival and five-year survival were similar in the two groups, the complication rate in the ER group was significantly lower than that in the RG group., Conclusion: ER is a good choice for patients with small EGC lesions (≤2 cm) without lymph node metastasis, especially in elderly patients with various medical comorbidities and in patients who cannot tolerate abdominal surgery or who meet the criteria but decline surgery. In contrast, RG is recommended when the diameter of the tumor is large (>2 cm) and preoperative examination suggests the possible presence of lymph node metastasis., (Copyright © 2017. Published by Elsevier Ltd.)