Alternative approaches to retroperitoneal lymph node dissection for paratesticular rhabdomyosarcoma.
J Pediatr Surg
; 55(12): 2677-2681, 2020 Dec.
Article
em En
| MEDLINE
| ID: mdl-32345499
PURPOSE: The aim of this study was to evaluate outcomes based on surgical approach for retroperitoneal lymph node dissection (RPLND) in patients with paratesticular rhabdomyosarcoma (PT-RMS). METHODS: Patients undergoing RPLND for PT-RMS over 10â¯years at a single institution were retrospectively reviewed. Length of stay (LOS), complications, oral morphine equivalents per kilogram (OME/Kg), lymph node yield, and time to chemotherapy were assessed. The surgical approaches compared were: open transabdominal, open extraperitoneal, laparoscopic, and retroperitoneoscopic. For cases with lymphatic mapping, indocyanine green (ICG) was injected into the spermatic cord. RESULTS: Twenty patients were included: five open transabdominal, six open extraperitoneal, three laparoscopic, and six retroperitoneoscopic operations. LOS was shorter in the retroperitoneoscopic group than laparoscopic (pâ¯=â¯0.029) and both open groups (pâ¯<â¯0.001). Mean OME/kg used was lowest in the retroperitoneoscopic (0.13⯱â¯0.15) group compared to laparoscopic (0.68⯱â¯0.53, pâ¯=â¯0.043), open transabdominal (14.90⯱â¯8.87, pâ¯=â¯0.003), and extraperitoneal (10.11⯱â¯2.44, pâ¯<â¯0.001). Time to chemotherapy was shorter for retroperitoneoscopic patients (0.13â¯days⯱â¯0.15) compared to open transabdominal (15.6â¯days±6.5, pâ¯=â¯0.005). There was no difference in lymph node yield between groups. Spermatic cord ICG demonstrated iliac lymph node avidity on near-infrared spectroscopy. CONCLUSIONS: Minimally invasive RPLND appears to offer a faster recovery without compromising lymph node yield for patients with PT-RMS. LEVEL OF EVIDENCE: III.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Rabdomiossarcoma
Tipo de estudo:
Observational_studies
Limite:
Humans
/
Male
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article