Robot-assisted supine extraperitoneal retroperitoneal lymph node dissection: a novel approach for template dissection in post-chemotherapy residual mass in non-seminomatous germ cell tumours

Pooleri, Ginil Kumar; Bijalwan, Priyank; Kesavan, Rajesh; Philip, Arun; Pavithran, Keechilat

doi:10.1007/s11701-018-0810-9

Cited by 6 publications

(6 citation statements)

References 8 publications

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Section: Resultsmentioning

confidence: 99%

“…A total of 37 studies [7,21–56] were included. Of these, 12 studies [7,21,23–25,28–32,34,35] described patients who underwent primary R‐RPLND only, 16 [38–53] described patients who underwent post‐chemotherapy R‐RPLND only, and six [22,26,27,33,36,37] included patients who underwent R‐RPLND in either of these settings. Two studies involving post‐chemotherapy RPLND were published from the same centre at two different time periods [39,41]; hence, the series published on a later date was included in the cumulative analysis [41].…”

Section: Resultsmentioning

confidence: 99%

“…Data for 188 patients who underwent post‐chemotherapy R‐RPLND was analysed. Tables 3 and 4 [22,26,27,33,36–38,40–53] describe the demographic and clinical characteristics of these patients and their perioperative outcomes. NSGCT was the most common indication for surgery (94.7%, 178/188).…”

Section: Resultsmentioning

confidence: 99%

“…Pooleri et al. [48] reported on extraperitoneal post‐chemotherapy R‐RPLND in the supine position for NSGCT using the da Vinci ® Xi system. The supine approach afforded the benefits of more physiological ventilatory pressures during prolonged anaesthesia, fewer position‐related complications, and more rapid emergency resuscitation if needed.…”

Section: Resultsmentioning

confidence: 99%

“…Extrapolating this to a robotic platform, Qin et al [30] first described the use of the extraperitoneal approach for primary R-RPLND in the flank position for Stage I right testicular NSGCT. Pooleri et al [48] reported on extraperitoneal post-chemotherapy R-RPLND in the supine position for NSGCT using the da Vinci â Xi system. The supine approach afforded the benefits of more physiological ventilatory pressures during prolonged anaesthesia, fewer position-related complications, and more rapid emergency resuscitation if needed.…”

Section: Transperitoneal Vs Extraperitoneal Approachmentioning

confidence: 99%

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Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

Garg¹,

Mansour²,

Psutka

et al. 2023

BJU International

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To assess the safety and feasibility of robot-assisted retroperitoneal lymph node dissection (R-RPLND) and to compare the perioperative outcomes of R-RPLND with open RPLND (O-RPLND), as RPLND forms an integral part of the management of testis cancer and R-RPLND is a minimally invasive treatment option for this disease. Materials and MethodsThe PubMed â , Scopus â , Cochrane Central Register of Controlled Trials, and Web of Science TM databases were searched for studies reporting perioperative outcomes of primary and post-chemotherapy R-RPLND and studies comparing R-RPLND with O-RPLND. ResultsThe search yielded 42 articles describing R-RPLND, including five comparative studies. The systematic review included 4222 patients (single-arm studies, n = 459; comparative studies, n = 3763). Of 459 patients in the single-arm studies, 271 underwent primary R-RPLND and 188 underwent post-chemotherapy R-RPLND. For primary R-RPLND, the operative time ranged from 175 to 540 min and the major complication rate was 4.1%. For post-chemotherapy R-RPLND, the operative time ranged from 134 to 550 min and the major complication rate was 8.5%. The conversion rate to open surgery was 2.2% in primary R-RPLND and 9.0% in post-chemotherapy R-RPLND. In comparison with O-RPLND, R-RPLND was associated with a lower transfusion rate (14.5% vs 0.9%, P < 0.001) and a lower complication rate (18.5% vs 7.8%, P = 0.002). ConclusionRobot-assisted RPLND has acceptable perioperative outcomes in both the primary and post-chemotherapy settings but a notable rate of conversion to open surgery in the post-chemotherapy setting. Compared with O-RPLND, R-RPLND is associated with a lower transfusion rate and fewer overall complications. Given the potential impact of selection bias, the optimal patient selection criteria for R-RPLND remain to be elucidated.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Transperitoneal Vs Extraperitoneal Approachmentioning

confidence: 99%

See 3 more Smart Citations

Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

Garg¹,

Mansour²,

Psutka

et al. 2023

BJU International

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Therapeutic supine robotic retroperitoneal lymph node dissection for post-chemotherapy residual masses in testicular cancer: technique and outcome analysis of initial experience

et al. 2019

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Lymph Node Dissection in Testicular Cancer: The State of the Art and Future Perspectives

Małkiewicz,

Świrkosz,

Lewandowski

et al. 2024

Curr Oncol Rep

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Purpose of Review This narrative review provides a comprehensive overview of the evolving role of retroperitoneal lymph node dissection (RPLND) in the management of testicular cancer (TC). It explores the significance of RPLND as both a diagnostic and therapeutic tool, highlighting its contribution to accurate staging, its impact on oncological outcomes, and its influence on subsequent treatment decisions. Recent Findings RPLND serves as an essential diagnostic procedure, aiding in the precise assessment of lymph node involvement and guiding personalized treatment strategies. It has demonstrated therapeutic value, particularly in patients with specific risk factors and disease stages, contributing to improved oncological outcomes and survival rates. Recent studies have emphasized the importance of meticulous patient selection and nerve-sparing techniques to mitigate complications while optimizing outcomes. Additionally, modern imaging and surgical approaches have expanded the potential applications of RPLND. Summary In the context of TC management, RPLND remains a valuable and evolving tool. Its dual role in staging and therapy underscores its relevance in contemporary urological practice. This review highlights the critical role of RPLND in enhancing patient care and shaping treatment strategies, emphasizing the need for further research to refine patient selection and surgical techniques.

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Robot-assisted supine extraperitoneal retroperitoneal lymph node dissection: a novel approach for template dissection in post-chemotherapy residual mass in non-seminomatous germ cell tumours

Cited by 6 publications

References 8 publications

Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

Robot‐assisted retroperitoneal lymph node dissection: a systematic review of perioperative outcomes

Therapeutic supine robotic retroperitoneal lymph node dissection for post-chemotherapy residual masses in testicular cancer: technique and outcome analysis of initial experience

Lymph Node Dissection in Testicular Cancer: The State of the Art and Future Perspectives

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