| Autor: |
Juravle, I., Dobrota, F., Crişan, N., Manea, C., Stanca, D. V., Coman, I. |
| Předmět: |
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| Zdroj: |
Romanian Journal of Urology; 2014, Vol. 13 Issue 1, p40-43, 4p |
| Abstrakt: |
Obiective: In this case report we describe the safety and feasibility of robotic surgery in retroperitoneal lymphadenectomy for testicular cancer and residual masses postchemotherapy, as it represents for Romania a national premier in robotic surgery. Introduction: DaVinci SI robotic surgical system is ideal for a retroperitoneal lymphadenectomy, because it facilitates the mobility of robotic surgical instruments due to the 7 degrees of freedom, and the optical system provides an improved image, which increases the safety and accuracy of this approach. Patients and method: Robotic retroperitoneal lymphadenectomy with transperitoneal approach was performed in a patient aged 24 years who was diagnosed with right testicular tumor in August 2012. After the right inguinal orchiectomy and the histopathologic exam which revealed pure testicular seminoma, the patient follower four cyles of chemotherapy. At 3 months after the last cycle of chemotherapy a 4 cm retroperitoneal residual mass, located above the right renal hilum and tangent to inferior vena cava has revealed. A retroperitoneal lymphadenectomy was performed by robotic transperitoneal approach. The standard area of ipsilateral lymphadenectomy was respected, including excision of residual mass. Results: The total operative time was 240 minutes and 180 minutes during the console. There were no intraoperative or postoperative incidents. There were about 350 ml blood loss and the patient did not require blood transfusion. Histopathologic examination of the residual mass revealed a cystic formation with mature teratoma component. On the operative specimen were identified three lymph nodes which were free to the histopathologic exam. The postoperative evolution was favorable and the patient was discharged at 5 days postoperatively. Conclusion: Robotic retroperitoneal lymphadenectomy is a feasible and safe technique in post-chemotherapy residual masses, in testicular cancer. [ABSTRACT FROM AUTHOR] |
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