Laparoscopic retroperitoneal lymph node dissection in clinical stage I nonseminomatous germ cell tumor: a minimal invasive alternative.

OBJECTIVE

To evaluate modified laparoscopic retroperitoneal lymph node dissection (LRPLND) performed for stage I nonseminomatous germ cell tumor.

METHODS

Between December 1993 and January 1996, modified unilateral laparoscopic retroperitoneal lymph node dissection was performed on 13 patients with nonseminomatous germ cell tumor of the testis. In 8 patients, the tumor was on the right side, and in 5, on the left.

RESULTS

The procedure was completed in 12 patients at a mean operating time of 292 min (range: 210-400 min). The mean estimated blood loss was 250 ml. The mean hospital stay was 6.4 days. Conversion to open surgery was required in one patient because of an uncontrollable venous bleeding. No other major complications occurred. Antegrade ejaculation was preserved in 10 patients, and the last 3 patients have not yet been addressed now.

CONCLUSIONS

Our results demonstrate that LRPLND is an accurate and reliable staging procedure with low morbidity, which allows quick patient discharge and rapid return to normal activity. For further evaluation, long follow-up in larger groups of patients is required.