Objective:To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy(R-RPLND)in the management of testicular cancer.Methods:A PubMed search for all relevant publications regarding t...Objective:To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy(R-RPLND)in the management of testicular cancer.Methods:A PubMed search for all relevant publications regarding the R-RPLND series up until August 2019 was performed.The largest series were identified,and weighted means calculated for outcomes using the number of patients included in each study as the weighting factor.Results:Fifty-six articles of R-RPLND were identified and eight series with more than 10 patients in each were included.The weighted mean age was 31.12 years;primary and post chemotherapy R-RPLND were performed in 50.59%and 49.41%of patients.The clinical stage was I,II and III in 47.20%,39.57%and 13.23%of patients.A modified R-RPLND template was used in 78.02%of patients,while 21.98%underwent bilateral full template.The weighted mean node yield,operative time and estimated blood loss were,respectively,22.15 nodes,277.35 min and 131.94 mL.The weighted mean length of hospital stay was 2 days and antegrade ejaculation was preserved in 92.12%of patients.Major post-operative complications(Clavien III or IV)occurred in 5.34%.Positive pathological nodes were detected in 24.54%,while the recurrence free survival was 95.77%with a follow-up of 21.81 months.Conclusion:R-RPLND has proven to be a reproducible and safe approach in experienced centers;short-term oncologic outcomes are similar to the open approach with less morbidity and shorter convalescence related to its minimal invasiveness.However,longer follow-up and new trials comparing head-to-head both techniques are expected.展开更多
文摘Objective:To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy(R-RPLND)in the management of testicular cancer.Methods:A PubMed search for all relevant publications regarding the R-RPLND series up until August 2019 was performed.The largest series were identified,and weighted means calculated for outcomes using the number of patients included in each study as the weighting factor.Results:Fifty-six articles of R-RPLND were identified and eight series with more than 10 patients in each were included.The weighted mean age was 31.12 years;primary and post chemotherapy R-RPLND were performed in 50.59%and 49.41%of patients.The clinical stage was I,II and III in 47.20%,39.57%and 13.23%of patients.A modified R-RPLND template was used in 78.02%of patients,while 21.98%underwent bilateral full template.The weighted mean node yield,operative time and estimated blood loss were,respectively,22.15 nodes,277.35 min and 131.94 mL.The weighted mean length of hospital stay was 2 days and antegrade ejaculation was preserved in 92.12%of patients.Major post-operative complications(Clavien III or IV)occurred in 5.34%.Positive pathological nodes were detected in 24.54%,while the recurrence free survival was 95.77%with a follow-up of 21.81 months.Conclusion:R-RPLND has proven to be a reproducible and safe approach in experienced centers;short-term oncologic outcomes are similar to the open approach with less morbidity and shorter convalescence related to its minimal invasiveness.However,longer follow-up and new trials comparing head-to-head both techniques are expected.
