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Robotic-assisted retroperitoneal lymph node dissection for stage II testicular cancer

Asian Journal of Urology 2024年第1期11卷 121-127页

作者： George McClintock Ahmed S.Goolam Don Perera Ryan Downey Scott Leslie Peter Grimison Henry Woo Peter Ferguson Nariman Ahmadi Department of Urology Chris O'Brien LifehouseSydneyNSWAustralia Department of Anaesthesia Chris O'Brien LifehouseSydneyNSWAustralia The University of Sydney SydneyNSW2006Australia Department of Medical Oncology Chris O'Brien LifehouseSydneyNSWAustralia

Objective:To evaluate the perioperative as well as early oncological outcomes of patients undergoing robotic retroperitoneal lymph node dissection for treatment of testicular ***:We conducted a prospective consecutive case series of patients undergoing robotic assisted retroperitoneal lymph node dissection for metastatic testicular cancer between May 2018 and July 2021 at our *** were collected on patient and tumour characteristics,intraoperative and postoperative parameters,and functional and oncological *** statistics are ***:Nineteen patients were identified;18(94.7%)completed the procedure robotically and one was converted to open surgery;78.9%of patients had stage≥IIB and 12(63.2%)patients had undergone prior *** median operative time was 300(interquartile range[IQR]240-315)*** blood loss was 100(IQR 50-175)*** length of stay was 2(range 1-11)*** robotically completed patients commenced diet and passed flatus on Day 1 and were discharged by Day *** median lymph node yield was 40.5(IQR 38-51)*** patients undergoing nerve-sparing procedures recovered antegrade ejaculatory *** patient had a Clavien-Dindo III complication(chylous ascites requiring drainage).At a median follow-up of 22.3(IQR 16.3-24.9)months,one patient developed retroperitoneal recurrence,which was successfully treated with second-line chemotherapy;no other patients have had ***:Robotic retroperitoneal lymph node dissection is a safe and feasible alternative to open surgery in appropriately selected patients,offering low *** oncological outcomes are *** cohorts and longer follow-ups are required to validate our institution's findings.

关键词： retroperitoneal lymph node dissection Robotic surgery Testicular cancer retroperitoneal node dissection

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Unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection in Stage II non-seminomatous germ cell tumor:A tertiary care experience

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Asian Journal of Urology 2023年第4期10卷 440-445页

作者： Dario Franzese Antonio Tufano Alessandro Izzo Raffaele Muscariello Giovanni Grimaldi Giuseppe Quarto Luigi Castaldo Sabrina Rossetti Savio Domenico Pandolfo Sonia Desicato Paola Del Prete Matteo Ferro Sandro Pignata Sisto Perdonà Department of Urology National Cancer InstitutePascale FoundationNaplesItaly Urology Unit Department of Maternal-Child and Urological Sciences“Sapienza”UniversityRomeItaly Department of Neurosciences Science of Reproduction and OdontostomatologyUniversity of Naples Federico IINaplesItaly Scientific Directorate Istituto Nazionale Tumori di NapoliIRCCS“G.Pascale”NaplesItaly Division of Urology European Institute of Oncology(IEO)IRCCSMilanItaly Division of Medical Oncology Department of Uro-Gynaecological OncologyIstituto Nazionale per lo Studio e la Cura dei Tumori“Fondazione G.Pascale”IRCCSNaplesItaly

Objective Post-chemotherapy retroperitoneal lymph node dissection(PC-RPLND)represents an integral component of the management of patients with non-seminomatous germ cell tumor(NSGCT).Modified templates have been proposed to minimize the surgical morbidity of the ***,the implementation of robotic surgery in this setting has been *** report our experience with unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection(PC-rRPLND)for clinical Stages IIA and IIB *** A retrospective single institution review was performed including 33 patients undergoing PC-rRPLND for Stages IIA and IIB NSGCTs between January 2015 and February *** orchiectomy,patients were scheduled for chemotherapy with three cycles of *** with a residual tumor oflymph node size at surgery was 25(interquartile range[IQR]21-36)*** operative time was 180(IQR 165-215)min and no major postoperative complications were *** ejaculation was preserved in 75.8%of *** follow-up was 26(IQR 19-30)months and a total of three recurrences were *** PC-rRPLND is a reliable and technically reproducible procedure with safe oncological outcomes and acceptable postoperative ejaculatory function in well selected patients with NSGCTs.

关键词： Testis tumor Robot-assisted retroperitoneal lymph node dissection retroperitoneal lymph node dissection Non-seminomatous germ cell tumor Unilateral dissection Modified template Post-chemotherapy

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Laparoscopic retroperitoneal lymph node dissection versus open retroperitoneal lymph node dissection for testicular cancer:A comparison of clinical and perioperative outcomes

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Asian Journal of Urology 2022年第2期9卷 119-124页

作者： Toshihide Shishido Takatsugu Okegawa Kenjiro Hayashi Kazuki Masuda Satoru Taguchi Yu Nakamura Mitsuhiro Tambo Hiroshi Fukuhara Department of Urology Hachioji Medical CenterTokyo Medical University1163TatemachiHachiojiTokyoJapan Department of Urology Kyorin University School of Medicine6-20-2 ShinkawaMitakaTokyoJap

Objective:This study was performed to evaluate the clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection(L-RPLND)and open retroperitoneal lymph node dissection(O-RPLND)performed by one surgeon at a single ***:We evaluated 30 patients with stage IIA germ cell tumors who underwent retroperitoneal lymph node dissection(15 underwent L-RPLND and 15 underwent O-RPLND)at our institution between April 1,2010 and March 31,*** clinical parameters were compared between patients who underwent L-RPLND using the retroperitoneal approach and those who underwent O-RPLND using the transperitoneal *** were no significant differences in the background characteristics of the two groups except for the median follow-up duration(46 months for L-RPLND and 71 months for O-RPLND,p=0.02).Results:L-RPLND was associated with a shorter mean operative time(mean 222 min for L-RPLND vs.453 min for O-RPLND,p<0.001).There was significantly less blood loss during surgery in the L-RPLND group compared to the O-RPLND group(mean 165 mL for L-RPLND vs.403 mL for O-RPLND,p<0.001).Parameters related to postoperative recovery were significantly better for the L-RPLND group than for the O-RPLND *** were no differences in the histopathological characteristics between the two *** patients in either group exhibited disease ***:Patients who underwent L-RPLND had more rapid recovery,and shorter hospital stay compared to those who underwent O-RPLND;complications were comparable between the two groups.L-RPLND is an efficient procedure with the benefits of minimally invasive surgery.

关键词： Laparoscopic surgery retroperitoneal lymph node dissection Testicular tumor

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***-term recovery of normal sexual function in lesticular cancer survivors

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Asian Journal of Andrology 2016年第1期18卷 85-89页

作者： Paolo Capogrosso Luca Boeri Matteo Ferrari Eugenio Ventimiglia Giovanni La Croce Umberto Capitanio Alberto Briganti Rocco Damiano Francesco Montorsi Andrea Salonia Universita Vita-Salute San Raffaele Milan Italy Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele Milan Italy Research Doctorate Program in Urology Magna Graecia University Catanzaro Italy

Testicular cancer （TC） is the most common solid cancer in men between the third and fourth decade of life. Due to successful treatment approaches, TC survivors （TCSs） have long life expectancy, but with numerous potential long-term sequelae, including sexual dysfunction. We investigated predictors of long-term normal sexual function （SF） recovery in TCSs. Sociodemographic, medical, and psychometric data were analyzed in 143 Caucasian-European TCSs, who underwent orchiectomy at a single institution. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI）. Patients completed the International Index of Erectile Function （IIEF）. Statistical models tested the association between predictors （including age at surgery, body mass index, CCI, and adjuvant therapy： radiotherapy [RT], chemotherapy [CT], CT followed by retroperitoneal lymph node dissection [RPLND] and RPLND alone） and the long-term recovery of normal SF （defined as IIEF-erectile function [EF] ≥26, and sexual desire [SD], intercourse satisfaction [IS] orgasmic function [OF], and overall satisfaction [OS] domain scores in the upper tertiles）. At a mean follow-up of 86 months, 35 （25.5%） TCSs had erectile dysfunction （ED）, with 16 （11.2%） experiencing severe ED. Median time of EF recovery was 60, 60, and 70 months after CT, RT, and RPLND, respectively. Only adjuvant RT emerged as an independent predictor of nonrecovery of normal EF （HR： 0.55, P = 0.01）. Neither adjuvant CT nor CT plus RPLND or RPLND alone significantly impaired the recovery of normal erections. Adjuvant therapy was not associated with impaired recovery of normal sexuality as a whole, considering the IIEF-SD, -OF, -IS, and OS domains.

关键词： chemotherapy erectile dysfunction radiotherapy retroperitoneal lymph node dissection survivors testicular cancer

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Treatment of clinical stage I non-seminoma

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Asian Journal of Urology 2021年第2期8卷 161-169页

作者： Christian Winter Andreas Hiester Department of Urology University of DuesseldorfMedical FacultyHeinrich-Heine-UniversityDuesseldorfGermany

Germ cell cancers are the most common solid tumors among men between 15 and 40 ***-seminomatous germ cell tumors(NSGCTs)represent a unique and exclusive cohort of germ cell tumor ***-seminoma can harbor different histologic *** most commonly found histologies are embryonal cell cancer,teratoma,yolk sack tumor and choriocarcinoma,as well as teratocarcinoma and seminoma,in combination with non-seminomatous germ cell tumors histologic *** clinical definition of stage I nonseminoma is the absence of metastatic lesions on imaging and normal tumor *** cure rate for clinical stage I NSGCT is 99%and this can be achieved by three therapeutic strategies:Active surveillance with treatment at the time of relapse,retroperitoneal lymph node dissection or adjuvant *** balancing of these various strategies should always be based on an individual risk profile of NGSCG patient depending on the lymphovascular invasion of the tumor.

关键词： Germ cell tumors Non-seminomatous germ cell tumors Active surveillance retroperitoneal lymph node dissection

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Mesenteric metastases from mature teratoma of the testis:A case report

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Asian Journal of Urology 2020年第3期7卷 322-325页

作者： Zoe Loh Todd G.Manning Jonathan S.O’Brien Marlon Perera Nathan Lawrentschuk Department of Surgery University of MelbourneAustin HealthMelbourneAustralia The Young Urology Researchers Organisation(YURO) Australia Faculty of Medicine University of QueenslandBrisbaneAustralia Department of Surgical Oncology Peter MacCallum Cancer CentreMelbourneAustralia Olivia Newton-John Cancer Research Institute MelbourneAustralia

Metastatic spread of testicular cancer has been well documented,with 95% of cases involving para-aortic retroperitoneal lymph *** lymphatic basins do not lie within the canonical drainage pathway of the testes and represent a rare site of *** mechanisms of spread to the mesentery have been described,including direct extension and haematogenous *** present a case of a previously-well 43-year-old man who presented with right scrotal discomfort and intermittent lower back pain,who was found to have mesenteric metastases from a non-seminomatous germ cell tumour of the *** lymphadenopathy that lies outside of standard resection templates remains a complex surgical *** we present the first case in the English medical literature with co-existing supradiaphragmatic axillary and mediastinal nodal disease.

关键词： Nonseminomatous germ cell tumour retroperitoneal lymph node dissection Mesentery Metastases Testicular cancer

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