Yang Hailiu, Obiora Daisy, Tomaszewski Jeffrey J
Division of Urology, Department of Surgery, Cooper University Hospital, Camden, NJ, USA.
Division of Urology, Department of Surgery, MD Anderson Cancer Center at Cooper, Cooper Medical School of Rowan University, Camden, NJ, USA.
Transl Androl Urol. 2021 May;10(5):2188-2194. doi: 10.21037/tau.2020.03.14.
Treatment of testicular cancer has made significant progress in the past decades in terms of reduction of treatment-associated morbidity and preventing over-treatment. At the forefront of this progression is utilization of the da Vinci robot to perform retroperitoneal lymph node dissections (RPLNDs) via a minimally invasive approach. The robot offers multiple potential advantages such as smaller incisions, improved 3D visualization, more precise dissection, and faster convalescence, leading to its increased usage the past several years. In this chapter, we summarize the recent progress made in robotic surgery for testicular cancer and its potential in the future. Promising preliminary data has also renewed interest in defining the role of primary RPLND in patients with seminoma, potentially sparing patients of the harmful long-term radiation and cisplatin-based chemotherapy. SEMS and PRIMETEST trials are ongoing trials that will provide significant insight into this area and potentially expand the role of robotic RPLND.
在过去几十年里，睾丸癌的治疗在降低治疗相关发病率和避免过度治疗方面取得了显著进展。这一进展的前沿是利用达芬奇机器人通过微创方法进行腹膜后淋巴结清扫术（RPLND）。该机器人具有多个潜在优势，如切口更小、三维可视化改善、解剖更精确以及恢复更快，导致其在过去几年中的使用增加。在本章中，我们总结了机器人手术治疗睾丸癌的最新进展及其未来潜力。有前景的初步数据也重新引发了人们对确定原发性RPLND在精原细胞瘤患者中的作用的兴趣，这可能使患者免受长期有害放疗和顺铂化疗之苦。SEMS和PRIMETEST试验正在进行中，将为该领域提供重要见解，并可能扩大机器人RPLND的作用。
