Complications of retroperitoneal lymphadenectomy in the management of nonseminomatous tumors of the testis
Waters, W.B.; Garnick, M.B.; Richie, J.P.
Surgery Gynecology and Obstetrics 154(4): 501-504
1982
ISSN/ISBN: 0039-6087 PMID: 7064080 Document Number: 186523
Retroperitoneal lymphadenectomy is the definitive operation for the accurate pathologic staging and treatment of Stage A, B1 and B2 nonseminomatous germ cell tumors of the testis. A review of 33 patients who underwent thoracoabdominal lymphadenectomy during a three year period yielded evidence of four minor complications and one major complication that resulted in the only operative death. The thoracoabdominal approach is preferred and allows one to palpate the ipsilateral thoracic cavity for unsuspected pulmonary metastasis to perform with greater ease bilateral dissection that includes a left suprahilar dissection, to use an extraperitoneal approach in patients without bulky abdominal disease--Stage B3 and C--and can be performed safely and with minimal morbidity and mortality by the well trained urologic surgeon.