Title: Safety and feasibility of minimally invasive gastrectomy following preoperative
chemotherapy for highly advanced gastric cancer
Version: 2 Date: 23 Nov 2023
Reviewer's report:
In this study, the authors determined the safety and feasibility of minimally invasive gastrectomy
in patients who underwent preoperative chemotherapy for highly advanced gastric cancer,
and they revealed that minimally invasive gastrectomy following preoperative chemotherapy
was feasible and safe for the subjects. Furthermore, they highlighted robotic gastrectomy may
improve surgical safety, particularly in the case of total/proximal gastrectomy combined with
splenectomy. This is an important report that objectively supports the progress and further
development of robotic gastrectomy. However, there are some remarks as listed below.
1. In this manuscript, the authors only describe the merits of RG, but are there no demerits in RG?
2. P7, line11-13#The authors described that ’we utilized near-infrared fluorescence imaging with
indocyanine green for splenectomy using the Firefly of da Vinci Xi system (Intuitive Surgical
Inc, USA), which enabled us to confirm the blood perfusion of the pancreatic tail to avoid the
occurrence of a refractory pancreatic fistula caused by ischemia.’. Actually, were there any cases
they confirmed ischemia of the pancreatic tail, and, if so, what countermeasure would they plan
to take?
3. In the ‘Operative outcomes and postoperative complications’ section of the ‘Results’,
considering the results of the second paragraph, isn't Supplementary Table 2 more important
than Table 2? The reviewer recommends swapping Table 2 with Supplementary Table 2.
4. Survival rates (3-year, 5-year, OS, RFS) in Table 4 are unnecessary, because they overlap
with the results in Figure 1A and B. Also, the authors need to add number at risk to each survival
curve.
Title: Safety and feasibility of minimally invasive gastrectomy following preoperative
chemotherapy for highly advanced gastric cancer
Version: 2 Date: 23 Nov 2023
Reviewer's report:
In this study, the authors determined the safety and feasibility of minimally invasive gastrectomy
in patients who underwent preoperative chemotherapy for highly advanced gastric cancer,
and they revealed that minimally invasive gastrectomy following preoperative chemotherapy
was feasible and safe for the subjects. Furthermore, they highlighted robotic gastrectomy may
improve surgical safety, particularly in the case of total/proximal gastrectomy combined with
splenectomy. This is an important report that objectively supports the progress and further
development of robotic gastrectomy. However, there are some remarks as listed below.
1. In this manuscript, the authors only describe the merits of RG, but are there no demerits in RG?
2. P7, line11-13#The authors described that ’we utilized near-infrared fluorescence imaging with
indocyanine green for splenectomy using the Firefly of da Vinci Xi system (Intuitive Surgical
Inc, USA), which enabled us to confirm the blood perfusion of the pancreatic tail to avoid the
occurrence of a refractory pancreatic fistula caused by ischemia.’. Actually, were there any cases
they confirmed ischemia of the pancreatic tail, and, if so, what countermeasure would they plan
to take?
3. In the ‘Operative outcomes and postoperative complications’ section of the ‘Results’,
considering the results of the second paragraph, isn't Supplementary Table 2 more important
than Table 2? The reviewer recommends swapping Table 2 with Supplementary Table 2.
4. Survival rates (3-year, 5-year, OS, RFS) in Table 4 are unnecessary, because they overlap
with the results in Figure 1A and B. Also, the authors need to add number at risk to each survival
curve.
Please review this paper.
user
Title: Safety and feasibility of minimally invasive gastrectomy following preoperative
chemotherapy for highly advanced gastric cancer
Version: 2 Date: 23 Nov 2023
Reviewer's report:
In this study, the authors determined the safety and feasibility of minimally invasive gastrectomy
in patients who underwent preoperative chemotherapy for highly advanced gastric cancer,
and they revealed that minimally invasive gastrectomy following preoperative chemotherapy
was feasible and safe for the subjects. Furthermore, they highlighted robotic gastrectomy may
improve surgical safety, particularly in the case of total/proximal gastrectomy combined with
splenectomy. This is an important report that objectively supports the progress and further
development of robotic gastrectomy. However, there are some remarks as listed below.
1. In this manuscript, the authors only describe the merits of RG, but are there no demerits in RG?
2. P7, line11-13#The authors described that ’we utilized near-infrared fluorescence imaging with
indocyanine green for splenectomy using the Firefly of da Vinci Xi system (Intuitive Surgical
Inc, USA), which enabled us to confirm the blood perfusion of the pancreatic tail to avoid the
occurrence of a refractory pancreatic fistula caused by ischemia.’. Actually, were there any cases
they confirmed ischemia of the pancreatic tail, and, if so, what countermeasure would they plan
to take?
3. In the ‘Operative outcomes and postoperative complications’ section of the ‘Results’,
considering the results of the second paragraph, isn't Supplementary Table 2 more important
than Table 2? The reviewer recommends swapping Table 2 with Supplementary Table 2.
4. Survival rates (3-year, 5-year, OS, RFS) in Table 4 are unnecessary, because they overlap
with the results in Figure 1A and B. Also, the authors need to add number at risk to each survival
curve.
assistant