Weissbach L, Boedefeld E A, Horstmann-Dubral B
Department of Urology, Krankenhaus Am Urban, Berlin, FRG.
Eur Urol. 1990;17(2):97-106. doi: 10.1159/000464015.
Final results of a prospective multicenter trial are presented comparing modified (ipsilateral) and radical retroperitoneal lymph node dissection (RLND) with regard to staging accuracy, curativity, and preserved ejaculation in stage-I non-seminomatous testis tumor. In 168 patients after modified and 67 patients after radical RLND, no differences were found in relapse rates (17 and 15%, respectively; median follow-up 30 months); in frequency of retroperitoneal relapse (2.4 and 1.5%, respectively), and intra-/postoperative complications (12 and 10%, respectively). Postoperative ejaculation was antegrade in 74 and 34%, (p less than 0.001), retrograde in 11 and 12% respectively. Normozoospermia was found in 50% of patients postoperatively vs. 20% preoperatively. Results are discussed in view of other alternatives. Modified RLND is considered an optimal approach to stage-I non-seminomatous germ cell testis tumor, outside specific trials.
本文呈现了一项前瞻性多中心试验的最终结果，该试验比较了改良（同侧）与根治性腹膜后淋巴结清扫术（RLND）在I期非精原细胞瘤性睾丸肿瘤的分期准确性、治愈率和保留射精功能方面的差异。在接受改良RLND的168例患者和接受根治性RLND的67例患者中，复发率（分别为17%和15%；中位随访30个月）、腹膜后复发频率（分别为2.4%和1.5%）以及术中和术后并发症（分别为12%和10%）均无差异。术后顺行射精分别为74%和34%（p<0.001），逆行射精分别为11%和12%。术后50%的患者精液正常，而术前为20%。结合其他替代方案对结果进行了讨论。在特定试验之外，改良RLND被认为是I期非精原细胞性生殖细胞睾丸肿瘤的最佳治疗方法。
