Laparoscopic retroperitoneal lymph node dissection (report of 7 cases) / 中华泌尿外科杂志

ABSTRACT

Objective To study the clinical efficacy of laparoscopic retroperitoneal lymph node dissection (LRPLND) for stage Ⅱ nonseminomatous testicular cancer. Methods Seven patients (mean ages 28 years, 4 had the tumors on the left side and 3 on the right) underwent LRPLND during 1 to 4 weeks after orchiectomy for clinical stage Ⅱ nonseminomatous testicular cancer. The dissection-al boundaries included the ipsilateral ureter laterally, the renal vessels superiorly, abdominal aorta and the bifurcation of the iliac artery inferiorly. The operative time, intraoperative blood loss, intra-or postoperative complications, tumor markers and ejaculation were observed. Results LRPLND was completed in all patients. Operative time ranged from 140 to 220 min (mean 180 min). Intraoperative blood loss ranged from 80 to 127 ml (mean 95 ml) and no transfusions were required. No intra- or postoperative complications occurred because of the procedure. At 2 weeks after operation, serum al-pha fetoprotein decreased from (15 to 1247 μg/L) to (2 to 8 μg/L), and beta human chorionic gona-dotropin decreased from (5 to 59 μg/L) to (0.5 to 2.5 μg/L). All patients recovered ejaculation dur-ing 10 to 12 weeks after operation. After a mean follow-up period of 21 months (range 12 to 26), no disease recurrence or metastasis was observed. Conclusion LRPLND is a safe, effective, minimally invasive procedure in the management of stage Ⅱ nonseminomatous testicular cancer patients.