Robot-Assisted Retroperitoneal Lymphadenectomy in Testicular Cancer Treatment: A Systematic Review

J Laparoendosc Adv Surg Tech A. 2018 Jun;28(6):682-689. doi: 10.1089/lap.2017.0672. Epub 2018 Feb 23.

Abstract

Introduction: Retroperitoneal lymph node dissection (RPLND) in testicular cancer is a documented treatment along with active surveillance and chemotherapy. This study aims to summarize the current evidence on the use of Robot-assisted RPLND (RARPLND) in comparison with the laparoscopic and open approach.

Materials and methods: A search was conducted in the existing literature focusing on reports with outcomes of RARPLND for stage I-IIB testicular tumor.

Results: Eleven studies complied with the inclusion criteria, including 116 patients. The average follow-up of 21.2 months showed no retroperitoneal recurrence. The median lymph node yield was 22.3 and the overall positive rate was 26%. Complications were encountered in 8% of the patients. The robotic approach showed similar results to the laparoscopic approach and outperformed the open procedure in perioperative parameters.

Conclusions: Relapse-free survival, nodal yield, and complication rates during RARPLND for clinical stage I-IIB are acceptable. Further studies are required to establish these findings and determine benefit from the use of robotic approach.

Keywords: NSGCT; RARPLND; non-seminomatous; robot-assisted retroperitoneal lymphadenectomy; testicular cancer.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Lymph Node Excision / adverse effects
  • Lymph Node Excision / methods*
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retroperitoneal Space / surgery
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / methods*
  • Testicular Neoplasms / pathology
  • Testicular Neoplasms / surgery*
  • Treatment Outcome