Retroperitoneal lymphadectomy: indications, complications and expectations.

The use of retroperitoneal lymphadenectomy in the management of 152 patients with nonseminomatous germ cell tumors of the testis treated at Anderson Hospital has been reviewed. Complications consisting of wound infection (six cases), acute pancreatitis (two cases), lymphocyst formation (two cases), and chylous ascites (one case) developed in 6.4% of patients. Although ejaculatory impotence is common postoperatively, only 12 marriage units were desirous of having children and 7 of these have had uncomplicated and successful pregnancies. No instances of erectile impotence developed in this series. The indications for the procedure have been defined with regard to accurate staging, combined therapy, and, in selected instances of advanced disease, as a means of monitoring the effects of chemotherapy. The importance of this operative procedure in the multimodal management of patients with nonseminomatous germ cell tumors of the testis cannot be overemphasized.