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Is there a limit for the laparoscopic approach of a retroperitoneal residual mass postchemotherapy?
- Source :
-
Actas urologicas espanolas [Actas Urol Esp] 2015 May; Vol. 39 (4), pp. 264-7. Date of Electronic Publication: 2015 Jan 22. - Publication Year :
- 2015
-
Abstract
- Objectives: Rescue lymphadenectomy for testicular cancer is a complex surgery, with a high number of complications. The laparoscopic approach appears to offer faster recovery and improved quality of life compared with open surgery. The aim of our study is to report on our experience and to define whether there is a limit (oncological, anatomical or technical) for laparoscopic management.<br />Material and Methods: A retrospective study was conducted of 15 patients who underwent laparoscopic retroperitoneal lymphadenectomy after chemotherapy. In addition to epidemiological and oncologic variables, we analyzed the mean surgical time, intraoperative and postoperative complications, the mean hospital stay and the mean follow-up time.<br />Results: The mean surgical time was 294 minutes (range, 180-240). There were 4 large-vessel vascular lesions, all of which were large-volume retroperitoneal masses, with diameters >7 cm. The rate of postoperative complications was 33%; there was only 1 case of Clavien >III. The mean hospital stay was 5.38 days (range, 2-9), and the mean patient follow-up was 28.9 months (range, 1-79). There was no recurrence in any of the cases.<br />Conclusions: The laparoscopic approach is an oncologically safe option for the rescue treatment of testicular cancer. The complex location of these masses entails the onset of severe intraoperative complications. We have observed a clear relationship between vascular complications and large masses (>7 cm). We therefore believe that it would be appropriate to establish a limit on the size for laparoscopic treatment.<br /> (Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.)
- Subjects :
- Adolescent
Adult
Antineoplastic Agents therapeutic use
Combined Modality Therapy
Follow-Up Studies
Germinoma drug therapy
Germinoma surgery
Humans
Intraoperative Complications epidemiology
Length of Stay statistics & numerical data
Male
Middle Aged
Operative Time
Orchiectomy
Postoperative Complications epidemiology
Retroperitoneal Neoplasms drug therapy
Retrospective Studies
Testicular Neoplasms drug therapy
Testicular Neoplasms surgery
Time Factors
Young Adult
Germinoma secondary
Laparoscopy methods
Lymph Node Excision methods
Lymphatic Metastasis
Retroperitoneal Neoplasms surgery
Salvage Therapy
Subjects
Details
- Language :
- English; Spanish; Castilian
- ISSN :
- 1699-7980
- Volume :
- 39
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Actas urologicas espanolas
- Publication Type :
- Academic Journal
- Accession number :
- 25619795
- Full Text :
- https://doi.org/10.1016/j.acuro.2014.10.008