Waters W B, Garnick M B, Richie J P
Surg Gynecol Obstet. 1982 Apr;154(4):501-4.
Retroperitoneal lymphadenectomy is the definitive operation for the accurate pathologic staging and treatment of Stage A, B1 and B2 nonseminomatous germ cell tumors of the testis. A review of 33 patients who underwent thoracoabdominal lymphadenectomy during a three year period yielded evidence of four minor complications and one major complication that resulted in the only operative death. The thoracoabdominal approach is preferred and allows one to palpate the ipsilateral thoracic cavity for unsuspected pulmonary metastasis to perform with greater ease bilateral dissection that includes a left suprahilar dissection, to use an extraperitoneal approach in patients without bulky abdominal disease--Stage B3 and C--and can be performed safely and with minimal morbidity and mortality by the well trained urologic surgeon.
腹膜后淋巴结清扫术是对睾丸A期、B1期和B2期非精原细胞性生殖细胞肿瘤进行准确病理分期和治疗的确定性手术。回顾33例在三年期间接受胸腹联合淋巴结清扫术的患者，发现有4例轻微并发症和1例严重并发症，后者导致了唯一的手术死亡。胸腹联合入路是首选，它能让术者触摸同侧胸腔，以便发现未被怀疑的肺转移，更轻松地进行双侧清扫，包括左肺门上方清扫；对于没有大量腹部病变的患者（B3期和C期），可采用腹膜外入路；并且训练有素的泌尿外科医生能够安全地进行该手术，使其发病率和死亡率降至最低。
