Linfadenectomía retroperitoneal robótica transmesocólica en tumores germinales de testículo no seminomatosos: un abordaje prometedor

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Actas urologicas espanolas Pub Date : 2025-06-01 DOI:10.1016/j.acuro.2025.501687

J. Palou, M. Casadevall, O. Rodríguez Faba, J.M. Gaya, A. Breda

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引用次数: 0

Abstract

Introduction

Testicular cancer accounts for 5% of urological tumors, with an incidence of 5.6 cases per 100,000 men per year in Europe. Salvage retroperitoneal lymphadenectomy is the standard surgery for persistent retroperitoneal masses after chemotherapy. The advent of minimally invasive surgery is changing the therapeutic approach. The objective is to present our initial experience with the transmesocolic robotic approach for the surgical management of these masses.

Methods

We report the perioperative and oncological outcomes of four patients affected by non-seminomatous germ cell tumors who were treated with transmesocolic robotic left para-aortic retroperitoneal lymphadenectomy.

Results

The surgical time for the first case was 220 minutes, and the average surgical time for the remaining cases was 120 minutes (SD: 15). Estimated blood loss was 82.5 ml (SD: 79.3). No intraoperative or postoperative complications were observed. Pathological anatomy revealed post-pubertal teratoma (30%) and necrosis (70%) in case 1, necrosis with reactive adenitis in case 2, extensive fibrosis in case 3 and post-pubertal teratoma in case 4. Currently, all patients are disease-free.

Conclusions

Robotic retroperitoneal lymphadenectomy is a safe and precise technique that offers favorable oncological and functional outcomes. The transmesocolic approach represents a feasible option in selected cases, ensuring rapid retroperitoneal access and reduced surgical time.

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非半乳突性睾丸生殖肿瘤间充质经腹膜后淋巴结切除术：一种很有前途的方法

睾丸癌占泌尿系统肿瘤的5%，在欧洲每年每10万男性中有5.6例的发病率。挽救性腹膜后淋巴结切除术是化疗后持续性腹膜后肿物的标准手术。微创手术的出现正在改变治疗方法。目的是介绍我们的初步经验，经肠系膜机器人入路手术处理这些肿块。方法报告4例非半原性生殖细胞肿瘤患者行经结肠左腹主动脉旁机器人腹膜后淋巴结切除术的围手术期及肿瘤预后。结果1例手术时间为220分钟，其余病例平均手术时间为120分钟（SD: 15）。估计失血量82.5 ml （SD: 79.3）。术中、术后均无并发症。病理解剖显示：病例1为青春期后畸胎瘤（30%）和坏死（70%），病例2为坏死伴反应性腺炎，病例3为广泛纤维化，病例4为青春期后畸胎瘤。目前，所有患者均无疾病。结论机器人腹膜后淋巴结切除术是一种安全、精确的技术，具有良好的肿瘤和功能预后。经结肠入路在特定病例中是一种可行的选择，可确保快速进入腹膜后并缩短手术时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Actas urologicas espanolas UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

46 days

期刊介绍： Actas Urológicas Españolas is an international journal dedicated to urological diseases and renal transplant. It has been the official publication of the Spanish Urology Association since 1974 and of the American Urology Confederation since 2008. Its articles cover all aspects related to urology. Actas Urológicas Españolas, governed by the peer review system (double blinded), is published online in Spanish and English. Consequently, manuscripts may be sent in Spanish or English and bidirectional free cost translation will be provided.