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Laparoscopic RPLND for testicular cancer

Shane M Pearce, Shay Golan, Michael A Gorin, Amy N Luckenbaugh, Stephen B Williams, John F Ward, Jeffrey S Montgomery, Khaled S Hafez, Alon Z Weizer, Phillip M Pierorazio, Mohamad E Allaf, Scott E Eggener
BACKGROUND: Primary robot-assisted retroperitoneal lymph node dissection (R-RPLND) has been studied as an alternative to open RPLND in single-institution series for patients with low-stage nonseminomatous germ cell tumors (NSGCT). OBJECTIVE: To evaluate a multicenter series of primary R-RPLND for low-stage NSGCT. DESIGN, SETTING, AND PARTICIPANTS: Between 2011 and 2015, 47 patients underwent primary R-RPLND at four centers for Clinical Stage (CS) I-IIA NSGCT...
May 24, 2016: European Urology
Sevan Stepanian, Mayank Patel, James Porter
BACKGROUND: Retroperitoneal lymph node dissection (RPLND) is an accepted staging and treatment option for nonseminomatous germ cell tumor. Robotic surgery offers technical advantages and is being increasingly used in urologic procedures. OBJECTIVE: To determine the feasibility and safety of robotic surgery for RPLND. DESIGN, SETTING, AND PARTICIPANTS: A retrospective review of robotic (R)-RPLND performed by a single surgeon from April 2008 to October 2014 using two approaches was performed...
April 5, 2016: European Urology
Heather J Chalfin, Wesley Ludwig, Phillip M Pierorazio, Mohamad E Allaf
Patients diagnosed with stage I non-seminomatous germ cell tumor (NSGCT) face the task of selecting a management strategy. Whereas these options all offer excellent survival, unfortunately, each has drawbacks. Retroperitoneal lymph node dissection (RPLND) is a major operation with low, but significant risks of bleeding, chylous ascites, and retrograde ejaculation. Platinum-based chemotherapy is associated with a number of long-term side effects, not all of which are quantified, but include secondary malignancy and early cardiovascular disease...
May 2016: Current Urology Reports
Haidar M Abdul-Muhsin, James O L'esperance, Kimberly Fischer, Michael E Woods, James R Porter, Erik P Castle
Robotic surgical techniques are now being applied in the setting of retroperitoneal lymphadenectomy (RPLND) for testicular cancer. While laparoscopic RPLND has not been widely accepted, reports of robot assisted RPLND (RARPLND) are emerging. This manuscript will review the application of RPLND for testicular cancer, evolution of minimally invasive techniques, the controversies, and current status of RARPLND.
December 2015: Journal of Surgical Oncology
Kelly T Harris, Michael A Gorin, Mark W Ball, Phillip M Pierorazio, Mohamad E Allaf
OBJECTIVE: To compare the safety and perioperative outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) vs laparoscopic RPLND (L-RPLND). PATIENTS AND METHODS: Our Institutional Review Board-approved retrospective testicular cancer registry was queried for patients who underwent a primary unilateral R-RPLND or L-RPLND by a single surgeon for a stage I testicular non-seminomatous germ cell tumour. Groups were compared for differences in baseline and outcome variables...
December 2015: BJU International
S Aufderklamm, T Todenhöfer, J Hennenlotter, J Mischinger, A Sim, J Böttge, S Rausch, S Bier, O Halalsheh, A Stenzl, G Gakis, C Schwentner
PURPOSE: Laparoscopic retroperitoneal lymph node dissection (L-RPLND) is often required in patients with metastatic nonseminomatous germ cell tumors (NSGCT) and residual tumors after chemotherapy. Laparoscopy has become established as a safe procedure in the surgical management of these tumors. Due to the rapid development of laparoscopy, complex retroperitoneal and even intrathoracic residuals can also be treated in high volume centers. PATIENTS AND METHODS: This study included 21 retrospectively identified NSGCT and seminoma patients (mean age 29 years) with metastatic disease and clinical stage (CS) IIA-IIIB...
July 2015: Der Urologe. Ausg. A
Yoichi Arai, Yasuhiro Kaiho, Shigeyuki Yamada, Hideo Saito, Koji Mitsuzuka, Shinichi Yamashita, Shunichi Namiki, Haruo Nakagawa, Shigeto Ishidoya, Akihiro Ito
PURPOSE: To assess the surgical and oncological outcomes of laparoscopic retroperitoneal lymph node dissection (RPLND) after chemotherapy. METHODS: Twenty patients with metastatic nonseminomatous testicular germ-cell tumor underwent extraperitoneal laparoscopic RPLND after chemotherapy. The procedure was not indicated for patients with a pre-chemotherapy mass larger than 5 cm. Morbidity and oncological outcome were reviewed retrospectively. Surgical complications were graded according to the Clavien classification system...
October 2012: International Urology and Nephrology
L Lusuardi, G Janetschek
The functional and oncological results of laparoscopic retroperitoneal lymphadenectomy (L-RPLND) have proven to be as efficacious as open series (O-RPLND) after 5 year follow-up. In the most recent publication series from high-volume laparoscopy centres, there was a trend towards fewer complications in L-RPLND compared to O-RPLND. Up to now only two case series of four treated patients have been reported adopting a robotic-assisted retroperitoneal lymphadenectomy for testicular cancer so that it is not yet possible to judge whether it is useful tool or not...
May 2012: Der Urologe. Ausg. A
X Durand, S Culine, P Camparo, C Avancès, P Sèbe, M Soulié, J Rigaud
INTRODUCTION: Postchemotherapy retroperitoneal lymphadenectomy (PC RPLDN) leads to an overall survival rate for testicular cancer exceeding 75%. Several questions still persist concerning: preoperative assessment of residual masses, reducing templates of dissection, choosing surgical approaches or including RPLND in high-risk patients' management. METHOD: The main series in the literature of the past 20 years were analyzed and selected to address these issues and reach a consensual diagnostic and therapeutic approach...
May 2012: Progrès en Urologie
Abai Xu, Hulin Li, Shaobo Zheng, Guoping Zhao, Haiyan Shen, Chunxiao Liu
OBJECTIVE: To summarize our initial experience with laparoendoscopic single-site (LESS) retroperitoneal lymph node dissection (RPLND) for treatment of nonseminomatous testicular cancer. METHODS: From September 2010 to June 2011, 3 patients (aged 19-27 years) with right testicle enlargement and elevated alpha-fetoprotein level underwent right radical orchidectomy. Histopathological analysis revealed nonseminomatous germ cell tumor. LESS-RPLND was performed 3 weeks after orchiectomy...
February 2012: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Michael W Gardner, Timur M Roytman, Cathy Chen, Steven B Brandes, Adam S Kibel, Robert L Grubb, Sam B Bhayani, Robert S Figenshau
BACKGROUND AND PURPOSE: At present, open retroperitoneal lymph node dissection (RPLND) remains the preferred approach at many high-volume centers for the surgical treatment of patients with low-stage testis cancer. Despite the potential advantages of a minimally invasive approach, including improved cosmesis and shorter recovery times, there remain concerns over the quality of dissection and oncologic control offered through a minimally invasive approach. Our objective was to critically evaluate the safety and intermediate-term oncologic efficacy of laparoscopic RPLND (L-RPLND)...
November 2011: Journal of Endourology
Willie Underwood, Hyung L Kim
OBJECTIVE: To assess the therapeutic efficacy of laparoscopic retroperitoneal lymph node dissection (L-RPLND) for testicular cancer in patients with nodal disease managed without adjuvant chemotherapy. PATIENTS AND METHODS: Consecutive patients undergoing RPLND were treated laparoscopically. Medical records for 15 patients with pathological stage I and II were reviewed. A modified template dissection was performed laparoscopically. When metastatic disease was noted on intraoperative frozen section, a bilateral template dissection was performed...
January 2012: BJU International
O A Castillo, R Sánchez-Salas, F P Secin, J M Campero, A Foneron, I Vidal-Mora
INTRODUCTION: this report is intended to retrospectively assess cancer control and morbidity of primary laparoscopic reproperitoneal lymphadenectomy (L-RPLND) in patients with clinical Stage I non seminomatous germ cell tumour (NSGCT). MATERIALS AND METHODS: one hundred and sixty-four patients with clinical Stage I NSGCT underwent primary diagnostic LRPLND between 1993 and 2006. Patients were operated unilaterally limiting the dissection to templates. Kaplan Meier curves were generated estimating time to recurrence...
January 2011: Actas Urologicas Españolas
Abbas Basiri, Mohammad Asl-Zare, Mehrdad Mohammadi Sichani, Hooman Djaladat
PURPOSE: We report our experience with laparoscopic bilateral retroperitoneal lymph node dissection (RPLND) in 4 patients with stage II testis cancer. MATERIALS AND METHODS: Between January 2002 and January 2009, 4 patients with stage II testis cancer underwent laparoscopic bilateral RPLND. In 2 patients, laparoscopic bilateral RPLND was performed for residual mass post-chemotherapy. We performed classic bilateral RPLND without patient repositioning. RESULTS: The procedure was done uneventfully without any major perioperative complication...
2010: Urology Journal
Andrew J Stephenson, Eric A Klein
The optimal treatment of low-stage nonseminomatous germ cell testicular cancer (NSGCT) is controversial. For clinical stage (CS) I NSGCT, retroperitoneal lymph node dissection (RPLND), two cycles of chemotherapy and surveillance are all accepted treatment options. For CS IIA-B, standard treatments include RPLND (+/- adjuvant chemotherapy) and induction chemotherapy (+/- RPLND). The long-term survival rate is >97% for CS I and 95% for CS IIA-B NSGCT, regardless of the treatment received. The risk of retroperitoneal metastasis varies by clinical stage (25-35% for CS I, 65-85% for CS IIA-B), and the presence of lymphovascular invasion and percentage of embryonal carcinoma in the primary tumour...
November 2009: BJU International
Stephen B Williams, David W McDermott, Dock Winston, Eamonn Bahnson, Alexander M Berry, Graeme S Steele, Jerome P Richie
OBJECTIVE: To review differences between primary retroperitoneal lymph node dissection (P-RPLND) and RPLND after chemotherapy (PC-RPLND) in a contemporary series of patients with testicular cancer, to validate the proposed low morbidity. PATIENTS AND METHODS: Patients who had undergone RPLND at our institution in 2001-2008 were identified and their clinical charts reviewed; in all, 190 were identified and perioperative data obtained. RESULTS: Of the 190 patients who had RPLND, 98 (52%) and 92 (48%) had P- and PC-RPLND, respectively...
April 2010: BJU International
Jean-Patrice Calestroupat, Rafael Sanchez-Salas, Xavier Cathelineau, Francois Rozet, Marc Galiano, Gordon Smyth, Ali Kasraeian, Eric Barret, Guy Vallancien
BACKGROUND AND PURPOSE: Postchemotherapy retroperitoneal lymph node dissection (RPLND) remains essential in the management of metastatic testicular carcinoma and represents a surgical challenge. We determined to assess the feasibility and complications of laparoscopic RPLND in patients who were treated with induction chemotherapy for testis cancer. PATIENTS AND METHODS: We performed a retrospective analysis of data that was prospectively recorded from 26 patients who underwent laparoscopic RPLND postplatinum-based chemotherapy between 2000 and 2006...
April 2009: Journal of Endourology
Jens J Rassweiler, Walter Scheitlin, Axel Heidenreich, M Pilar Laguna, Günter Janetschek
CONTEXT: Laparoscopic retroperitoneal lymph node dissection (L-RPLND) is not recommended as standard tool in European Association of Urology (EAU) guidelines. OBJECTIVE: To update the role of L-RPLND in patients with clinical stage I nonseminomatous germ cell tumour (NSGCT) compared to open retroperitoneal lymph node dissection (O-RPLND). EVIDENCE ACQUISITION: A systematic literature search from 1992 to 2008 was performed in Medline, EMBASE, and Cochrane...
November 2008: European Urology
T A Skolarus, S B Bhayani, H C Chiang, S B Brandes, A S Kibel, J Landman, R S Figenshau
BACKGROUND AND PURPOSE: Current management options for low-stage mixed malignant germ-cell testicular tumors (MMGCT) after radical orchiectomy include surveillance, chemotherapy, or retroperitoneal lymph node dissection (RPLND). The open RPLND is the surgical gold standard and has been duplicated laparoscopically with confirmed diagnostic effectiveness; however, its therapeutic oncologic value in MMGCT has never been proven. We present our laparoscopic RPLND (L-RPLND) data for low-stage MMGCT and paratesticular rhabdomyosarcoma...
July 2008: Journal of Endourology
Patrick A Kenney, Ingolf A Tuerk
OBJECTIVES: A proposed benefit of laparoscopic retroperitoneal lymph node dissection (LRPLND) is more favorable morbidity in comparison to open retroperitoneal lymph node dissection (RPLND). The objective of this review is to examine and summarize the literature regarding complications in both primary and post-chemotherapy LRPLND (PC-LRPLND) and, where appropriate, we include the opinions of the senior author regarding management. METHODS: A MEDLINE search was performed using the terms "laparoscopy" or "laparoscopic," "retroperitoneal lymph node dissection" or "RPLND," and "testicular neoplasms...
December 2008: World Journal of Urology
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