Laparoscopic Retroperitoneal Lymph Node Dissection: Transperitoneal Approach
To lower the morbidity of retroperitoneal lymphadenectomy, the procedure was modified over the past 35 years from extended suprahilar to bilateral infrahilar, and subsequently a modified laparoscopic unilateral approach then a nerve-sparing technique was introduced. There was no increase in relapse rates associated with the introduction of these operative refinements; significant factors for relapse were pathological stage (P < 0.001) and adjuvant chemotherapy in stage II disease (P < 0.001) . Laparoscopic retroperitoneal lymph node dissection (RPLND) has been advocated and utilized in the management of testicular cancer over the past decade. This method technically duplicates the open surgical technique and has demonstrated its surgical and oncologic efficacy. The morbidity and complication rates are low. Tumor recurrence rates after laparoscopic RPLND are comparable to those of open surgery. Laparoscopic RPLND is safe, with less postoperative morbidity, quicker convalescence, improved cosmetic results, and a diagnostic accuracy equal to that of the open technique.
KeywordsTesticular cancer Retroperitoneal lymph node dissection Laparoscopy Transperitoneal approach Chemotherapy
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