The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, 600 N. Wolfe Street, Park 223, Baltimore, MD 21287, USA.
Ther Adv Urol. 2009 Jun;1(2):107-14. doi: 10.1177/1756287209104830.
Open retroperitoneal lymph node dissection has been traditionally used for the management of patients with nonseminomatous germ-cell tumors (NSGCTs). Over the last decade, laparoscopic retroperitoneal lymph node dissection (LRPLND) has gained popularity in several highly specialized centers.
We retrospectively reviewed the English-language literature with regard to LRPLND. The perioperative and oncologic outcomes for patients with low stage NSGCTs who underwent LRPLND are summarized in this review with particular emphasis on contemporary studies.
Initially only used for staging, LRPLND has evolved to a therapeutic procedure capable of replicating the templates used for open RPLND. Perioperative outcomes including operative time, conversion rates and complications improve with surgeon experience and are acceptable at high volume centers. Oncologic outcomes are promising, but require longer term follow-up and the administration of adjuvant chemotherapy in many studies limits comparison to that of the open technique.
LRPLND has been demonstrated to be feasible and safe at large volume institutions with experienced laparoscopic surgeons. LRPLND was originally performed as a staging procedure in patients with NSGCTs but has evolved into a therapeutic operation with early reports demonstrating short hospital stays and minimal morbidity. Further studies in larger cohorts of patients with longer term follow up are required to define the exact role of LRPLND.
开放性腹膜后淋巴结清扫术传统上用于治疗非精原细胞瘤生殖细胞肿瘤（NSGCTs）患者。在过去十年中，腹腔镜腹膜后淋巴结清扫术（LRPLND）在几个高度专业化的中心得到了普及。
我们回顾了英语文献中关于 LRPLND 的内容。本文总结了接受 LRPLND 的低分期 NSGCT 患者的围手术期和肿瘤学结果，特别强调了当代研究。
最初仅用于分期，LRPLND 已发展成为一种能够复制开放式 RPLND 模板的治疗性手术。随着外科医生经验的增加，包括手术时间、转换率和并发症在内的围手术期结果得到改善，并且在高容量中心是可以接受的。肿瘤学结果很有希望，但需要长期随访，并且在许多研究中辅助化疗的应用限制了与开放式技术的比较。
在有经验的腹腔镜外科医生的大型医疗机构中，LRPLND 已被证明是可行且安全的。LRPLND 最初是作为 NSGCTs 患者的分期手术进行的，但已发展成为一种治疗性手术，早期报告显示其住院时间短，发病率低。需要进一步对更多患者进行长期随访的研究，以确定 LRPLND 的确切作用。
