文章：

国家转诊中心对转移性睾丸癌患者进行化疗后腹膜后淋巴结清扫术

Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer at a National Referral Centre

原文发布日期：11 February 2025

DOI: 10.3390/cancers17040608

类型: Article

开放获取: 是

英文摘要：

Objective: To assess the safety of open PC-RPLND at a high-volume national referral centre over the course of several years. Materials and Methods: A retrospective chart review of patients with testicular germ cell tumours (TGCTs) who underwent PC-RPLND at our institution between 2008 and 2023 was conducted. Patient demographics, clinical characteristics, intraoperative and postoperative parameters and adjunctive procedures were recorded. ClassIntra and Clavien Dindo classifications were used to assess intraoperative and postoperative complications, respectively. Results: In total, 165 patients were studied. The median (Q1–Q3) age of patients was 30.5 years (24.75–38.25), and the median maximum diameter of retroperitoneal masses was 50 mm (26.75–81.25). The most common adjunctive procedure was synchronous nephrectomy (n= 18, 11%) followed by vascular procedures (n = 7, 4.3%), ureteric reconstruction (n = 7, 4.3%), and partial hepatectomy (n = 3, 1.9%). Intraoperatively, 20, 8 and 1 patient had a grade I, II or V complication, respectively, according to the ClassIntra classification. The median estimated blood loss was 300 mL (120–740), the median duration of the procedure was 4.9 h (4–6 h) and the median length of stay was 8 days (7–10 days). Histopathological examination of the resected specimen showed teratoma in 51.9% of patients, followed by fibrosis/necrosis in 39.5%. A total of 40 patients (24.7%) experienced at least one complication. Conclusions: PC-RPLND is a complex operation, often accompanied by adjunctive surgical procedures and therefore must be conducted in high-volume referral centres to ensure safety and minimise complications.

摘要翻译： 

目的：评估一家高手术量的国家级转诊中心在多年间开展开放性腹膜后淋巴结清扫术（PC-RPLND）的安全性。材料与方法：回顾性分析2008年至2023年间在本机构接受PC-RPLND的睾丸生殖细胞肿瘤（TGCT）患者的病历资料。记录患者人口统计学特征、临床特征、术中及术后参数以及附加手术操作。分别采用ClassIntra分级和Clavien-Dindo分级评估术中及术后并发症。结果：共纳入165例患者。患者中位年龄（Q1-Q3）为30.5岁（24.75-38.25），腹膜后肿块最大直径中位数为50毫米（26.75-81.25）。最常见的附加手术为同期肾切除术（18例，11%），其次为血管手术（7例，4.3%）、输尿管重建术（7例，4.3%）和部分肝切除术（3例，1.9%）。根据ClassIntra分级，术中分别有20例、8例和1例患者发生Ⅰ级、Ⅱ级和Ⅴ级并发症。中位估计失血量为300毫升（120-740），中位手术时长为4.9小时（4-6小时），中位住院时间为8天（7-10天）。切除标本的病理学检查显示51.9%的患者存在畸胎瘤，其次为纤维化/坏死（39.5%）。共有40例患者（24.7%）发生至少一种并发症。结论：PC-RPLND是一项复杂的手术，常需联合附加外科操作，因此必须在高手术量的转诊中心开展以确保安全性并最大限度减少并发症。

原文链接：

Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Metastatic Testicular Cancer at a National Referral Centre