Yansheng Xu1, Hongzhao Li2, Baojun Wang3, Liangyou Gu4, Yu Gao5, Yang Fan6, Yuanxin Yao7, XengInn Fam8, Xin Ma9, Xu Zhang10. 1. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. drxuys@163.com. 2. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. urolancet@126.com. 3. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. baojun40009@126.com. 4. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. Guliangyouyd1@126.com. 5. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. tjgaoyu@163.com. 6. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. kevinvan2000@163.com. 7. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. yzydxd@163.com. 8. Urology unit, Surgery Department, UKM Medical Centre, Kuala Lumpur Malaysia . xenginn@gmail.com. 9. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. urologist@foxmail.com. 10. Department of Urology, the Third Medical Center, Chinese PLA General Hospital, Beijing, China. xzhang@tjh.tjmu.edu.cn.
Abstract
PURPOSE: To compare the treatment outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) versus laparoscopic RPLND (L-RPLND) for clinical stage I non-seminomatous germ cell testicular tumors (NSGCTs). MATERIALS AND METHODS: We retrospectively reviewed the data of patients with stage I NSGCTs who underwent robotic or laparoscopic RPLND between 2008 and 2017. Perioperative data and oncologic outcomes were reviewed and compared between the two groups. Progression-free survival was analyzed using Kaplan-Meier survival curves and compared between two groups. RESULTS: A total of 31 and 28 patients underwent R-RPLND and L-RPLND respectively. The preoperative characteristics of the patients were comparable in the two groups. Patients in R-RPLND group had significantly shorter median operative time (140 vs. 175 minutes, P < .001), a shorter median duration to surgical drain removal (2 vs. 4 days, P = .002) and a shorter median postoperative hospital stay (5 vs. 6 days, P = .001). There were no statistical differences in intra- and post-operative complication rate between the groups and the oncologic outcomes were similar in the two groups. CONCLUSION: In expert hands, R-RPLND and L-RPLND were comparable in oncological parameter and morbidity rate; R-RPLND showed superiority in operation duration, median days to surgical drain removal and postoperative hospital stay for stage I NSGCTs. Multicenter and randomized studies with good power of study and sufficient follow-up duration are required to validate our result.
PURPOSE: To compare the treatment outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) versus laparoscopic RPLND (L-RPLND) for clinical stage I non-seminomatous germ cell testicular tumors (NSGCTs). MATERIALS AND METHODS: We retrospectively reviewed the data of patients with stage I NSGCTs who underwent robotic or laparoscopic RPLND between 2008 and 2017. Perioperative data and oncologic outcomes were reviewed and compared between the two groups. Progression-free survival was analyzed using Kaplan-Meier survival curves and compared between two groups. RESULTS: A total of 31 and 28 patients underwent R-RPLND and L-RPLND respectively. The preoperative characteristics of the patients were comparable in the two groups. Patients in R-RPLND group had significantly shorter median operative time (140 vs. 175 minutes, P < .001), a shorter median duration to surgical drain removal (2 vs. 4 days, P = .002) and a shorter median postoperative hospital stay (5 vs. 6 days, P = .001). There were no statistical differences in intra- and post-operative complication rate between the groups and the oncologic outcomes were similar in the two groups. CONCLUSION: In expert hands, R-RPLND and L-RPLND were comparable in oncological parameter and morbidity rate; R-RPLND showed superiority in operation duration, median days to surgical drain removal and postoperative hospital stay for stage I NSGCTs. Multicenter and randomized studies with good power of study and sufficient follow-up duration are required to validate our result.