GIULIANO BETONI GUGLIELMETTI

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Instituto do Câncer do Estado de São Paulo, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina

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  • article 9 Citação(ões) na Scopus
    Robot-assisted retroperitoneal lymphadenectomy: The state of art
    (2021) RODRIGUES, Gilberto J.; GUGLIELMETTI, Giuliano B.; ORVIETO, Marcelo; BHAT, Kulthe Ramesh Seetharam; PATEL, Vipul R.; COELHO, Rafael F.
    Objective: To perform a narrative review about the role of robot-assisted retroperitoneal lymphadenectomy (R-RPLND) in the management of testicular cancer. Methods: A PubMed search for all relevant publications regarding the R-RPLND series up until August 2019 was performed. The largest series were identified, and weighted means calculated for outcomes using the number of patients included in each study as the weighting factor. Results: Fifty-six articles of R-RPLND were identified and eight series with more than 10 patients in each were included. The weighted mean age was 31.12 years; primary and post chemotherapy R-RPLND were performed in 50.59% and 49.41% of patients. The clinical stage was I, II and III in 47.20%, 39.57% and 13.23% of patients. A modified R-RPLND template was used in 78.02% of patients, while 21.98% underwent bilateral full template. The weighted mean node yield, operative time and estimated blood loss were, respectively, 22.15 nodes, 277.35 min and 131.94 mL. The weighted mean length of hospital stay was 2 days and ante grade ejaculation was preserved in 92.12% of patients. Major post-operative complications (Clavien III or IV) occurred in 5.34%. Positive pathological nodes were detected in 24.54%, while the recurrence free survival was 95.77% with a follow-up of 21.81 months. Conclusion: R-RPLND has proven to be a reproducible and safe approach in experienced centers; short-term oncologic outcomes are similar to the open approach with less morbidity and shorter convalescence related to its minimal invasiveness. However, longer follow-up and new trials comparing head-to-head both techniques are expected. (c) 2021 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.
  • article 5 Citação(ões) na Scopus
    Robot-assisted endoscopic inguinal lymphadenectomy: A review of current outcomes
    (2021) RODRIGUES, Gilberto Jose; GUGLIELMETTI, Giuliano Betoni; ORVIETO, Marcelo; BHAT, Kulthe Ramesh Seetharam; PATEL, Vipul R.; COELHO, Rafael Ferreira
    Objective: To review the role of robot-assisted endoscopic inguinal lymphadenectomy (RAIL) in the management of penile cancer. Methods: A PubMed search for all relevant publications regarding RAIL series up until August 2019 was performed using the keyword ""robotic"", "" inguinal lymph node dissection"", and ""penile cancer"". Weighted mean was calculated in the largest series for all outcomes using the number of patients included in each study as the weighting factor. Results: We identified 23 articles, of note the three largest series that included 102, 27, and 20 RAIL in 51, 14, and 10 patients, respectively. Saphenous vein was spared in 88.93% of RAIL cases in these series and node yield was 11.42 per groin; 35.28% of patients had positive pathological nodes. The weighted mean of operative time was 87.98 min per RAIL and the estimated blood loss was 37.08 mL per patient. The mean length of hospital stay was 1.29 days and the drain was kept in place for 17.02 days; the major complication rate was only 5.31% in these series. The mean follow-up was 33.46 months with a recurrence-free survival of 96.33%. Conclusion: The literature regarding RAIL describes promising results, although it has shorter follow-up and higher costs when compared to historically series from the open approach. Initials series reported lower cutaneous complications compared to conventional approach, without compromising oncological outcomes. However, long-term results and larger trials are crucial to validate those findings. (C) 2021 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.