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机器人辅助腹膜后淋巴结清扫术在睾丸癌治疗中的应用:一项系统综述

Robot-Assisted Retroperitoneal Lymphadenectomy in Testicular Cancer Treatment: A Systematic Review.

作者信息

Tselos Aggelos, Moris Demetrios, Tsilimigras Diamantis I, Fragkiadis Evangelos, Mpaili Eustratia, Sakarellos Panagiotis, Vailas Michail, Shah Kevin N, Papalampros Alexandros

机构信息

1 1st Department of Surgery, Laikon General Hospital, University of Athens , Athens, Greece .

2 Department of Surgery, Duke University Medical Center , Durham, North Carolina.

出版信息

J Laparoendosc Adv Surg Tech A. 2018 Jun;28(6):682-689. doi: 10.1089/lap.2017.0672. Epub 2018 Feb 23.

Abstract

INTRODUCTION

Retroperitoneal lymph node dissection (RPLND) in testicular cancer is a documented treatment along with active surveillance and chemotherapy. This study aims to summarize the current evidence on the use of Robot-assisted RPLND (RARPLND) in comparison with the laparoscopic and open approach.

MATERIALS AND METHODS

A search was conducted in the existing literature focusing on reports with outcomes of RARPLND for stage I-IIB testicular tumor.

RESULTS

Eleven studies complied with the inclusion criteria, including 116 patients. The average follow-up of 21.2 months showed no retroperitoneal recurrence. The median lymph node yield was 22.3 and the overall positive rate was 26%. Complications were encountered in 8% of the patients. The robotic approach showed similar results to the laparoscopic approach and outperformed the open procedure in perioperative parameters.

CONCLUSIONS

Relapse-free survival, nodal yield, and complication rates during RARPLND for clinical stage I-IIB are acceptable. Further studies are required to establish these findings and determine benefit from the use of robotic approach.

摘要

引言

睾丸癌的腹膜后淋巴结清扫术(RPLND)是一种有文献记载的治疗方法,与主动监测和化疗一样。本研究旨在总结与腹腔镜和开放手术相比,机器人辅助腹膜后淋巴结清扫术(RARPLND)应用的当前证据。

材料与方法

在现有文献中进行检索,重点关注关于I-IIB期睾丸肿瘤RARPLND结果的报告。

结果

11项研究符合纳入标准,包括116例患者。平均21.2个月的随访显示无腹膜后复发。淋巴结中位数取出量为22.3个,总体阳性率为26%。8%的患者出现并发症。机器人手术方法在围手术期参数方面显示出与腹腔镜手术方法相似的结果,且优于开放手术。

结论

临床I-IIB期RARPLND期间的无复发生存率、淋巴结取出量和并发症发生率是可接受的。需要进一步研究来证实这些发现,并确定使用机器人手术方法的益处。

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