Department of Urology, Heinrich-Heine University Dusseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
World J Urol. 2017 Aug;35(8):1185-1190. doi: 10.1007/s00345-016-1984-2. Epub 2016 Dec 21.
Residual tumor resection in patients with advanced testicular tumor plays a vital role in the multimodal treatment. Treatment indications for residual tumor resection have changed over the last two decades. While patients with advanced seminoma after chemotherapy or radiotherapy rarely need surgery, it is mandatory for most non-seminomatous tumor patients to undergo post-chemotherapy tumor resection. Due to adjunctive surgical procedures, the operation is surgically demanding and should be performed only in specialized high-volume referral centers. Additional surgical procedures such as nephrectomy, partial colectomy or vascular interventions including caval and aortic resection with grafting might be required. Consequently, several complications can be seen in the peri- and postoperative course. We aim to describe indications for residual tumor resection, operative technique, including adjunctive surgeries and the most common peri- and postoperative complications.
在多模态治疗中,晚期睾丸肿瘤患者的残余肿瘤切除起着至关重要的作用。过去二十年中,残余肿瘤切除的治疗指征发生了变化。虽然化疗或放疗后晚期精原细胞瘤患者很少需要手术,但大多数非精原细胞瘤患者必须进行化疗后肿瘤切除术。由于辅助手术,手术要求较高,只能在专门的高容量转诊中心进行。可能需要附加手术,如肾切除术、部分结肠切除术或血管介入术,包括腔静脉和腹主动脉切除术及移植。因此,在围手术期可能会出现多种并发症。我们旨在描述残余肿瘤切除的适应证、手术技术,包括辅助手术和最常见的围手术期并发症。