PDF(Pubmed)
Abstract：
UNASSIGNED: 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 procedure. Moreover, the implementation of robotic surgery in this setting has been explored. We report our experience with unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection (PC-rRPLND) for clinical Stages IIA and IIB NSGCTs.
UNASSIGNED: A retrospective single institution review was performed including 33 patients undergoing PC-rRPLND for Stages IIA and IIB NSGCTs between January 2015 and February 2019. Following orchiectomy, patients were scheduled for chemotherapy with three cycles of bleomycin-etoposide-cisplatin. Patients with a residual tumor of <5 cm and an ipsilateral metastatic disease on pre- and post-chemotherapy CT scans were eligible for a unilateral template in absence of rising tumor markers. Descriptive statistics were provided for demographics, clinical characteristics, intraoperative and postoperative parameters. Perioperative, oncological, and functional outcomes were recorded.
UNASSIGNED: Overall, 7 (21.2%) patients exhibited necrosis or fibrosis; 14 (42.4%) had mature teratoma; and 12 (36.4%) had viable tumor at final histology. The median lymph node size at surgery was 25 (interquartile range [IQR] 21-36) mm. Median operative time was 180 (IQR 165-215) min and no major postoperative complications were observed. Anterograde ejaculation was preserved in 75.8% of patients. Median follow-up was 26 (IQR 19-30) months and a total of three recurrences were recorded.
UNASSIGNED: PC-rRPLND is a reliable and technically reproducible procedure with safe oncological outcomes and acceptable postoperative ejaculatory function in well selected patients with NSGCTs.
UNASSIGNED: A retrospective single institution review was performed including 33 patients undergoing PC-rRPLND for Stages IIA and IIB NSGCTs between January 2015 and February 2019. Following orchiectomy, patients were scheduled for chemotherapy with three cycles of bleomycin-etoposide-cisplatin. Patients with a residual tumor of <5 cm and an ipsilateral metastatic disease on pre- and post-chemotherapy CT scans were eligible for a unilateral template in absence of rising tumor markers. Descriptive statistics were provided for demographics, clinical characteristics, intraoperative and postoperative parameters. Perioperative, oncological, and functional outcomes were recorded.
UNASSIGNED: Overall, 7 (21.2%) patients exhibited necrosis or fibrosis; 14 (42.4%) had mature teratoma; and 12 (36.4%) had viable tumor at final histology. The median lymph node size at surgery was 25 (interquartile range [IQR] 21-36) mm. Median operative time was 180 (IQR 165-215) min and no major postoperative complications were observed. Anterograde ejaculation was preserved in 75.8% of patients. Median follow-up was 26 (IQR 19-30) months and a total of three recurrences were recorded.
UNASSIGNED: PC-rRPLND is a reliable and technically reproducible procedure with safe oncological outcomes and acceptable postoperative ejaculatory function in well selected patients with NSGCTs.
摘要：
■化疗后腹膜后淋巴结清扫术（PC-RPLND）代表了非精原细胞生殖细胞肿瘤（NSGCT）患者治疗的组成部分。已经提出了修改的模板以最小化手术的手术发病率。此外，已经探索了在这种环境下机器人手术的实施。我们报告了用于临床IIA和IIBNSGCT的单侧化疗后机器人辅助腹膜后淋巴结清扫术（PC-rRPLND）的经验。
进行了回顾性单机构审查，包括在2015年1月至2019年2月期间接受PC-rRPLND进行IIA期和IIB期NSGCT的33例患者。睾丸切除术后,患者计划接受3个周期的博莱霉素-依托泊苷-顺铂化疗.在化疗前后CT扫描中，残留肿瘤<5cm且同侧转移性疾病的患者有资格在没有升高的肿瘤标志物的情况下获得单侧模板。提供了人口统计学的描述性统计数据，临床特征,术中和术后参数。围手术期,肿瘤学，并记录功能结局.
■总的来说，7例（21.2％）患者出现坏死或纤维化；14例（42.4％）患有成熟畸胎瘤；12例（36.4％）在最终组织学上有存活肿瘤。手术时的中位淋巴结大小为25（四分位距[IQR]21-36）mm。中位手术时间为180（IQR165-215）min，未观察到主要的术后并发症。75.8％的患者保留了顺行射精。中位随访时间为26（IQR19-30）个月，共记录3次复发。
■PC-rRPLND是一种可靠且技术上可重复的手术，在精心选择的NSGCT患者中具有安全的肿瘤结局和可接受的术后射精功能。
进行了回顾性单机构审查，包括在2015年1月至2019年2月期间接受PC-rRPLND进行IIA期和IIB期NSGCT的33例患者。睾丸切除术后,患者计划接受3个周期的博莱霉素-依托泊苷-顺铂化疗.在化疗前后CT扫描中，残留肿瘤<5cm且同侧转移性疾病的患者有资格在没有升高的肿瘤标志物的情况下获得单侧模板。提供了人口统计学的描述性统计数据，临床特征,术中和术后参数。围手术期,肿瘤学，并记录功能结局.
■总的来说，7例（21.2％）患者出现坏死或纤维化；14例（42.4％）患有成熟畸胎瘤；12例（36.4％）在最终组织学上有存活肿瘤。手术时的中位淋巴结大小为25（四分位距[IQR]21-36）mm。中位手术时间为180（IQR165-215）min，未观察到主要的术后并发症。75.8％的患者保留了顺行射精。中位随访时间为26（IQR19-30）个月，共记录3次复发。
■PC-rRPLND是一种可靠且技术上可重复的手术，在精心选择的NSGCT患者中具有安全的肿瘤结局和可接受的术后射精功能。
