Robotic retroperitoneal surgery in a uro-oncology specialised centre: Translating RPLND expertise from testicular cancer to non-genitourinary retroperitoneal tumour resection

在泌尿肿瘤专科中心开展机器人辅助腹膜后手术:将睾丸癌腹膜后淋巴结清扫术(RPLND)的经验应用于非泌尿生殖系统腹膜后肿瘤切除术

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Abstract

OBJECTIVE: The aim of this study is to evaluate the feasibility and perioperative outcomes of robotic-assisted resection of selected non-genitourinary retroperitoneal tumours (RA-RTR) performed by urologists with established experience in robotic retroperitoneal lymph node dissection (RA-RPLND) within a specialised centre. METHODS: A retrospective analysis was conducted of all patients undergoing RA-RPLND for testicular cancer and RA-RTR for non-genitourinary tumours between January 2022 and May 2025. Procedures for renal, adrenal and upper tract urothelial malignancies were excluded. All operations were performed using a four-port da Vinci Xi® platform. RESULTS: Forty-five patients were included: 27 RA-RPLND and 18 RA-RTR. RA-RTR patients were older (median 50 vs. 36 years, p = 0.024). Preoperative tumour size was larger in RA-RTR (56 mm vs. 20 mm, p < 0.001), although specimen dimensions were similar. Operative time was longer for RA-RPLND (143 vs. 90 min, p = 0.045). Estimated blood loss (40 vs. 20 mL, p = 0.077) and length of stay (1 vs. 2 days, p = 0.272) were comparable. No conversions or transfusions occurred. Complication rates did not differ (14.8% vs. 5.6%, p = 0.333), and all cases achieved negative margins. CONCLUSION: Comparable perioperative outcomes between RA-RTR and RA-RPLND indicate that these surgeries can be performed in specialised centres by urologists experienced in complex retroperitoneal surgery.

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