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机器人辅助腹腔镜下睾丸癌腹膜后淋巴结清扫术的结果与技术综述

A Review of Outcomes and Technique for the Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection for Testicular Cancer.

作者信息

Schwen Zeyad R, Gupta Mohit, Pierorazio Phillip M

机构信息

Department of Urology, James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

出版信息

Adv Urol. 2018 May 3;2018:2146080. doi: 10.1155/2018/2146080. eCollection 2018.

Abstract

OBJECTIVES

The robotic-assisted laparoscopic retroperitoneal lymph node dissection (R-RPLND) represents a new frontier in the surgical management of testicular cancer in the realm of minimally invasive urologic oncology. We aimed to review the early outcomes as compared to the laparoscopic and open approaches as well as describe the operative technique for the R-RPLND.

MATERIALS AND METHODS

We reviewed all the literature related to the R-RPLND based on an electronic PubMed search up until July 2017.

RESULTS AND DISCUSSION

Encouraged by favorable early oncologic and safety outcomes for treatment of clinical stage (CS) I nonseminomatous germ cell tumor (NSGCT), the R-RPLND affords the same recovery advantages as the laparoscopic retroperitoneal lymph node dissection (L-RPLND) while offering greater dexterity, superior visualization, and a theoretically shorter learning curve for the surgeon. While R-RPLND has a promising future in the management of patients with primary and postchemotherapy NSGCT, larger and more vigorous prospective studies are needed before supplanting the open RPLND as the gold standard approach for primary low-stage NSGCT or becoming an equivalent surgical modality in the postchemotherapy setting.

摘要

目的

机器人辅助腹腔镜腹膜后淋巴结清扫术(R-RPLND)代表了微创泌尿外科肿瘤学领域中睾丸癌外科治疗的一个新前沿。我们旨在回顾与腹腔镜和开放手术方法相比的早期结果,并描述R-RPLND的手术技术。

材料与方法

我们基于截至2017年7月的电子PubMed搜索,回顾了所有与R-RPLND相关的文献。

结果与讨论

受临床分期(CS)I期非精原细胞性生殖细胞肿瘤(NSGCT)治疗早期肿瘤学和安全性良好结果的鼓舞,R-RPLND具有与腹腔镜腹膜后淋巴结清扫术(L-RPLND)相同的恢复优势,同时为外科医生提供了更高的灵活性、更好的视野以及理论上更短的学习曲线。虽然R-RPLND在原发性和化疗后NSGCT患者的管理方面有着光明的未来,但在取代开放RPLND成为原发性低分期NSGCT的金标准方法或在化疗后环境中成为等效的手术方式之前,还需要更大规模和更有力的前瞻性研究。

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本文引用的文献

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Testicular Cancer, Version 2.2015.睾丸癌临床实践指南(2015 年第 2 版)
J Natl Compr Canc Netw. 2015 Jun;13(6):772-99. doi: 10.6004/jnccn.2015.0092.

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