Laparoscopic retroperitoneal lymphnode dissection for testicular cancer: Nagoya experience
Matsunuma, H.; Ono, Y.; Hattori, R.; Gotoh, M.; Yoshino, Y.; Ohshima, S.
Hinyokika Kiyo. Acta Urologica Japonica 49(7): 377-380
2003
ISSN/ISBN: 0018-1994 PMID: 12968476 Document Number: 562396
Three patients with stage I disease and 3 patients with stage III disease were treated with laparoscopic retroperitoneal lymphnode dissection. The patient was placed in a semilateral position and 5 trocars were introduced through the lateral abdominal wall. After incising the peritoneum along the Toldt line, the colon was reflected medially and the retroperitoneal structures such as the ureter, aorta, inferior vena cava and both renal arteries and veins were exposed. For right-side disease the paracaval and interaortocaval lymphnodes were dissected, and for left-side disease, the interaortocaval and paraaortic lymphnodes were dissected. The procedure was completed successfully on all 6 patients. The average operative time was 3.4 hours for 3 patients with stage I disease and 4.4 hours for 3 patients with stage III disease treated with prior chemotherapy. All patients started to walk and resumed oral intake from the first post-operative day and the average duration to full convalescence was 21 days. Anteriograde ejaculation and erection were preserved in all six patients. Laparoscopic retroperitoneal lymphonode dissection will be a useful technique for management of testicular cancer.