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Laparoscopic retroperitoneal lymph node dissection for stage I and II nonseminomatous germ-cell tumors
Therapeutic Advances in Urology, 06/29/09

Guzzo TJ et al. - In a review of laparoscopic retroperitoneal lymph node dissection (LRPLND) for stage I and II nonseminomatous germ-cell tumors, LRPLND is feasible and safe at large volume institutions with experienced laparoscopic surgeons. LRPLND was originally performed as a staging procedure in pts with nonseminomatous germ-cell tumors (NSGCTs), but has evolved into a therapeutic operation with early reports demonstrating short hospital stays and minimal morbidity.

Methods

English-language literature was retrospectively reviewed with regard to LRPLND.
Perioperative and oncologic outcomes for pts with low-stage NSGCTs who underwent LRPLND are summarized in this review with particular emphasis on contemporary studies.

Results

Initially only used for staging, LRPLND has evolved to a therapeutic procedure capable of replicating 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 administration of adjuvant chemotherapy in many studies limits comparison to that of the open technique.

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