1.Interim analysis of short-term outcomes between robotic and laparoscopic surgery for colon cancer: results from the ESSIMIC trial
Marco MILONE ; Sara VERTALDI ; Pietro ANOLDO ; Simona BORIN ; Graziano CECCARELLI ; Anna D’AMORE ; Maurizio DEGIULI ; Paolo DELRIO ; Uberto Romario FUMAGALLI ; Mario GUERRIERI ; Michele MANIGRASSO ; Monica ORTENZI ; Ugo PACE ; Felice PIROZZI ; Lucia PUCA ; Wanda PETZ ; Rossella REDDAVID ; Daniela REGA ; Fabio RONDELLI ; Antonio SCIUTO ; Giovanni Domenico DE PALMA
Annals of Coloproctology 2026;42(1):86-93
Purpose:
This study aimed to determine whether the benefits of robotic surgery can be applied to the treatment of colon cancer by evaluating short-term outcomes of robotic versus laparoscopic colonic resection.
Methods:
This interim analysis of an interventional multicenter randomized trial was conducted to compare outcomes of robotic and laparoscopic colorectal surgery performed between January 2017 and December 2019. The study specifically assessed short-term outcomes in patients undergoing laparoscopic or robotic right or left colectomy for cancer. In addition, all short-term outcomes were evaluated in separate subgroups of right and left colonic resections through prespecified subgroup analyses.
Results:
A total of 323 patients were analyzed, of whom 142 underwent robotic-assisted surgery and 181 underwent laparoscopic surgery. Overall, 109 complications (33.7%) occurred in the short-term period, 41 (28.9%) in the robotic group and 68 (37.6%) in the laparoscopic group, with no differences between groups in intraoperative or postoperative complications. However, grade III complications were significantly more frequent in the laparoscopic group, with 17 cases (9.4%) compared to 5 cases (3.5%) in the robotic group. Oncological radicality was similar between groups. Functional recovery after surgery was superior in the robotic group, as reflected by a shorter time to mobilization (17.5±10.2 hours vs. 21.1±11.5 hours). In the right colectomy subgroup, rates of grade III complications (1.9% vs. 11.7%) and lymph nodes retrieved (20.3±10.3 vs. 20.2±6.4) favored robotic surgery. In the left colon cancer subgroup, functional recovery was also improved with robotic surgery (44.3±22.2 hours vs. 61.1±31.1 hours, as measured by the composite recovery outcome).
Conclusion
Robotic surgery is associated with fewer severe complications and improved postoperative recovery following colonic resections. Trial registration: ClinicalTrials.gov identifier: NCT02871960
2.Single-loop versus double-loop reconstruction after pancreatoduodenectomy: Does it impact on the risk of postoperative pancreatic fistula?
Giovanni Domenico TEBALA ; Fanny MASSIMI ; Francesca DURO ; Ahmed ABDELSAMAD ; Stefano AVENIA ; Gian Luca BAIOCCHI ; Andrea BARBERIS ; Chafik BOUZID ; Antoine CASTEL ; Graziano CECCARELLI ; Andrea CELOTTI ; Nicola CILLARA ; Nicola CINARDI ; Roberto CIROCCHI ; Maria CONTICCHIO ; Giuseppe CURRÒ ; Antonella DELVECCHIO ; Raffaele Vincenzo De ROSA ; Jacopo DESIDERIO ; Antonio Di CINTIO ; Fabio Francesco Di MOLA ; Domenico Di NARDO ; Alessia FASSARI ; Alessandro GEMINI ; Carlos Augusto GOMES ; Gian Luca GRAZI ; Giuseppe MARGANI ; Alessandro MAZZOTTA ; Luca MORELLI ; Andrea MURATORE ; Fabrice MUSCARI ; Edoardo Maria MUTTILLO ; Alberto PATRITI ; Gaetano PICCOLO ; Luca PROPERZI ; Alessandro PUZZIELLO ; Lucia ROMANO ; Edoardo ROSSO ; Sara SAEIDI ; Andrea SAGNOTTA ; Edoardo SALADINO ; Marcello Giuseppe SPAMPINATO ; Laurent SULPICE ; Nádia TENREIRO ; Paolo UBIALI ; Riccardo MEMEO ;
Annals of Hepato-Biliary-Pancreatic Surgery 2026;30(2):192-202
Background:
s/Aims: Postoperative pancreatic fistula (POPF) remains a significant complication following pancreatoduodenectomy (PD). It has been hypothesized that single loop (SL) reconstruction may increase the risk of POPF, leading to the proposal of double-loop (DL) reconstruction. In this approach, the pancreatic duct is connected to an isolated loop of bowel in a Roux-en-Y configuration.
Methods:
We conducted a retrospective multicenter study to compare various types of reconstruction after PD, analyzing data from 1,502 patients who underwent open, laparoscopic, or robotic PD across 28 centers worldwide. Propensity score matching (PSM) was applied to enhance comparability.
Results:
The overall rate of POPF was 34.89%, with a grade C POPF rate of 4.26%. The type of reconstruction (SL vs. DL) did not significantly impact the rates of POPF or grade C POPF, both before and after PSM. The rate of delayed gastric emptying (DGE) was 20.71%, and patients with DL reconstruction had a lower incidence of DGE both before and after PSM.
Conclusions
Our study found no significant differences in the risk of POPF between SL and DL reconstruction. However, DL reconstruction is associated with a reduced risk of DGE, suggesting it may be a preferable option following open PD.

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