SURGICAL AND ONCOLOGICAL OUTCOMES OF THERAPEUTIC POST-CHEMOTHERAPY ROBOT-ASSISTED RETROPERITONEAL LYMPH NODE DISSECTION FOR TESTICULAR CANCER

You have accessJournal of UrologyMisc GU Oncology, Complications & Techniques (V09)1 Apr 2019V09-07 SURGICAL AND ONCOLOGICAL OUTCOMES OF THERAPEUTIC POST-CHEMOTHERAPY ROBOT-ASSISTED RETROPERITONEAL LYMPH NODE DISSECTION FOR TESTICULAR CANCER Hailiu Yang*, Vijay Raj, Robert Brown, and Jeffrey Tomaszewski Hailiu Yang*Hailiu Yang* More articles by this author , Vijay RajVijay Raj More articles by this author , Robert BrownRobert Brown More articles by this author , and Jeffrey TomaszewskiJeffrey Tomaszewski More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556987.23478.85AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Robotic-assisted retroperitoneal lymph node dissection (RA-RPLND) was first reported by Davol et al. in 2006 [1]. Several small series of primary RA-RPLND have reported acceptable oncologic and functional outcomes [1-5]. Post-chemotherapy RPLND, however, is far more technically challenging given the desmoplastic reaction and bulky residual disease. Only a small handful of post-chemotherapy RA-RPLNDs have been reported. Cheney reported a series of 17 RA-RPLNDs [6], including 8 who had a post-chemotherapy RPLND. Of those 8 patients, 2 were converted to open due to robotic malfunction and poor exposure. Additionally, 3 patients were deemed ineligible for robotic surgery due to bulky disease. Kamel, et. al. [7] also described a series of 12 post-chemotherapy RA-RPLND. 11 of 12 surgeries were completed robotically but the mean number of lymph nodes excised was only 12. Further studies are needed to determine the feasibility of RA-RPLNDs. METHODS: We queried the medical records at our institution for all men who have undergone a robotic full-template bilateral retroperitoneal lymph node dissection in the post-chemotherapy setting between 2014 and 2018. We collected data retrospectively and reported the surgical and oncological outcomes. RESULTS: In total, we identified 7 patients treated with robotic full-template post-chemotherapy RPLND. The overall and major complication rates were 57.1% and 28.6%, respectively. One patient required open conversion. The observed morbidity of RA-RPLND was comparable to rates reported in large open series [8] (21% complication rate; 28% rate of additional procedures). Median operative time was 353 min, with a median estimated blood loss of 50 cc. The median length of stay was 2 days, which is comparable to other laparoscopic and robotic series. 1 patient had retrograde ejaculation post-op. There were no recurrences in the retroperitoneum at a median follow-up of 7 months. CONCLUSIONS: Post-chemotherapy RA-RPLND is feasible and provides acceptable oncologic outcomes and peri-operative morbidity in select patients. Further studies are needed to generalize our single institution experience and validate its efficacy compared to the open approach. Source of Funding: none Camden, NJ© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e938-e938 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hailiu Yang* More articles by this author Vijay Raj More articles by this author Robert Brown More articles by this author Jeffrey Tomaszewski More articles by this author Expand All Advertisement PDF downloadLoading ...