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Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer—IMIGASTRIC
  1. Jacopo Desiderio1,
  2. Zhi-Wei Jiang2,
  3. Ninh T Nguyen3,
  4. Shu Zhang2,
  5. Daniel Reim4,
  6. Orhan Alimoglu5,
  7. Juan-Santiago Azagra6,
  8. Pei-Wu Yu7,
  9. Natalie G Coburn8,
  10. Feng Qi9,
  11. Patrick G Jackson10,
  12. Lu Zang11,
  13. Steven T Brower12,
  14. Yukinori Kurokawa13,
  15. Olivier Facy14,
  16. Hironori Tsujimoto15,
  17. Andrea Coratti16,
  18. Mario Annecchiarico16,
  19. Francesca Bazzocchi17,
  20. Andrea Avanzolini17,
  21. Johan Gagniere18,
  22. Denis Pezet18,
  23. Fabio Cianchi19,
  24. Benedetta Badii19,
  25. Alexander Novotny4,
  26. Tunc Eren5,
  27. Metin Leblebici5,
  28. Martine Goergen6,
  29. Ben Zhang7,
  30. Yong-Liang Zhao7,
  31. Tong Liu9,
  32. Waddah Al-Refaie10,
  33. Junjun Ma11,
  34. Shuji Takiguchi13,
  35. Jean-Baptiste Lequeu14,
  36. Stefano Trastulli1,
  37. Amilcare Parisi1
  1. 1Department of Digestive Surgery, St Mary's Hospital, University of Perugia, Terni, Italy
  2. 2Department of General Surgery, Jinling Hospital, Medical School, Nanjing University, Nanjing, China
  3. 3Department of Surgery, Division of Gastrointestinal Surgery, University of California, Irvine Medical Center, Orange, California, USA
  4. 4Chirurgische Klinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universität München, München, Germany
  5. 5Department of General Surgery, School of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
  6. 6Unité des Maladies de l'Appareil Digestif et Endocrine (UMADE), Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
  7. 7Department of General Surgery, Third Military Medical University Southwest Hospital, Chongqing, China
  8. 8Division of General Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada
  9. 9Department of Gastrointestinal Surgery, Tianjin Medical University General Hospital, Tianjin, China
  10. 10Division of General Surgery, Medstar Georgetown University Hospital, Washington DC, USA
  11. 11Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University, School of Medicine, Shanghai, China
  12. 12Department of Surgical Oncology and HPB Surgery, Englewood Hospital and Medical Center, Englewood, New Jersey, USA
  13. 13Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
  14. 14Service de chirurgie digestive et cancérologique CHU Bocage. Dijon, France
  15. 15Department of Surgery, National Defense Medical College, Tokorozawa, Japan
  16. 16Division of Oncological and Robotic Surgery, Department of Oncology, Careggi University Hospital, Florence, Italy
  17. 17Department of General Surgery, Division of General, Gastroenterologic and Minimally Invasive Surgery, GB Morgagni Hospital, Forlì, Italy
  18. 18Digestive and Hepatobiliary Surgery Department, University of Auvergne, University Hospital Estaing, Clermont-Ferrand, France
  19. 19Department of Surgery and Translational Medicine, Center of Oncological Minimally Invasive Surgery (COMIS), University of Florence, Florence, Italy
  1. Correspondence to Dr Jacopo Desiderio; djdesi85{at}


Introduction Gastric cancer represents a great challenge for healthcare providers and requires a multidisciplinary treatment approach in which surgery plays a major role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and recently with the spread of robotic surgery, but a number of issues are currently being debated, including the limitations in performing an effective extended lymph node dissection, the real advantages of robotic systems, the role of laparoscopy for Advanced Gastric Cancer, the reproducibility of a total intracorporeal technique and the oncological results achievable during long-term follow-up.

Methods and analysis A multi-institutional international database will be established to evaluate the role of robotic, laparoscopic and open approaches in gastric cancer, comprising of information regarding surgical, clinical and oncological features. A chart review will be conducted to enter data of participants with gastric cancer, previously treated at the participating institutions. The database is the first of its kind, through an international electronic submission system and a HIPPA protected real time data repository from high volume gastric cancer centres.

Ethics and dissemination This study is conducted in compliance with ethical principles originating from the Helsinki Declaration, within the guidelines of Good Clinical Practice and relevant laws/regulations. A multicentre study with a large number of patients will permit further investigation of the safety and efficacy as well as the long-term outcomes of robotic, laparoscopic and open approaches for the management of gastric cancer.

Trial registration number NCT02325453; Pre-results.


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