Laparoscopic lumbar-aortic lymphadenectomy in residual post-chemotherapy tumours in testicular cancer - Abstract

INTRODUCTION: Open lumbar-aortic lymphadenectomy (OLAL) is the gold standard for treating post-chemotherapy retroperitoneal masses.

Laparoscopic OLAL (L-OLAL) has emerged in recent years as an alternative for the handling of patients with these masses, with the additional potential benefits of minimal invasion.

OBJECTIVE: To present our experience with the laparoscopic handling (L-OLAL) of residual post-chemotherapy masses in patients with advanced testicular cancer.

MATERIAL AND METHODS: Between 1993 and 2009, 43 patients underwent post-chemotherapy L-OLAL. A transperitoneal technique was employed in all patients. We assessed demographic, perioperational and pathological variables, as well as complications and follow-up.

RESULTS: A unilateral dissection was performed in 17 patients, while 26 patients underwent a bilateral retroperitoneal dissection. In the first group, 4 patients relapsed. In the second group, there were no relapses. After an average follow-up of 21 months, the overall survival rate reached 95%. We recorded a rate of perioperative complications of only 9.3%.

CONCLUSIONS: In experienced hands, L-OLAL is a technically feasible surgical alternative for the treatment of patients who are carriers of advanced testicular cancer with residual post-chemotherapy masses. The dissection performed should be bilateral to avoid tumour relapses and increase the survival rate of these patients.

Written by:
Castillo OA, Landerer E, Vidal-Mora I.   Are you the author?
Departamento de Urología, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile.

Reference: Actas Urol Esp. 2013 May 2. pii: S0210-4806(13)00006-5.
doi: 10.1016/j.acuro.2013.01.004

PubMed Abstract
PMID: 23643570

Article in English, Spanish. Testicular Cancer Section