Simforoosh Nasser, Nasseh Hamidreza, Masoudi Parham, Aslzare Mohammad, Ghahestani Seyyed Mohammad, Eshratkhah Ramin, Radfar Mohammad Hadi
Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2012 Spring;9(2):480-5.
To evaluate the outcome of laparoscopic retroperitoneal lymph node dissection (LRPLND) using bipolar electrocoagulation instead of clipping the lymphatic vessels.
Between August 2002 and April 2008, a total of 13 patients underwent transperitoneal LPRLND for nonseminomatous germ cell tumor of the testis. In this experience, in contrast to other techniques, we did not use clips for ligation of the lymphatic vessels; instead, we used bipolar cautery for coagulation of the lymphatic vessels. We followed up the patients for lymphocele formation or lymphatic leakage using abdominal computed tomography scan.
Mean age of the patients was 24.2 years (range, 19 to 39 years). Six tumors were on the left side and 7 on the right. Pathological stage was I in 12 patients and IIA in one. The mean follow-up period was 29.9 months (range, 3 to 70 months). No re-operation was required. There was no prolonged lymphatic leakage or lymphocele formation during the follow-up period.
Our study demonstrates that using bipolar electrocoagulation instead of clips, for sealing of the lymphatic vessels during LRPLND, does not hamper the outcome of the procedure. This should be further evaluated in randomized clinical trials with more subjects.
评估在腹腔镜腹膜后淋巴结清扫术（LRPLND）中使用双极电凝而非夹闭淋巴管的效果。
2002年8月至2008年4月期间，共有13例患者因睾丸非精原细胞瘤接受了经腹LRPLND。在本研究中，与其他技术不同，我们未使用夹子结扎淋巴管；相反，我们使用双极电凝来凝固淋巴管。我们通过腹部计算机断层扫描对患者进行随访，观察有无淋巴囊肿形成或淋巴漏。
患者的平均年龄为24.2岁（范围19至39岁）。6例肿瘤位于左侧，7例位于右侧。12例患者的病理分期为I期，1例为IIA期。平均随访期为29.9个月（范围3至70个月）。无需再次手术。随访期间无持续性淋巴漏或淋巴囊肿形成。
我们的研究表明，在LRPLND中使用双极电凝而非夹子来封闭淋巴管，不会影响手术效果。这应在更多受试者参与的随机临床试验中进一步评估。
