ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Laparoscopic Retroperitoneal Lymph Node Dissection
Dr. Can ÖBEK,a Dr. Faruk YENCİLEKa
aÜroloji AD, Yeditepe Üniversitesi Tıp Fakültesi, İSTANBUL
The optimum management of patients with stage I non-seminomatous germ cell tumors (NSGCT) following radical orchiectomy remains controversial. Overall survival is in the range of 95-98% with all treatment options. The controversy is about providing the patient with the best treatment with least morbidity and minimum compromise from quality of life. Retroperitoneal lymph node dissection (RPLND), adjuvant chemotherapy in high risk patients, and surveillance in low risk patients are the current treatment options. The major advantage of RPLND is proper staging. In addition, RPLND may provide cure in some patients with low volume retroperitoneal metastatic disease. However, open RPLND requires a large incision and thus is associated with significant morbidity. Laparoscopic RPLND (L-RPLND) has emerged as a less invasive alternative to the open counterpart, while maintaining the advantages of open surgery. Its safety and efficacy has been proven in experienced centers. Blood loss, post-operative pain, and hospital stay are significantly less and patients return to daily routine weeks earlier with the laparoscopic approach. The role of L-RPLND as a curative approach in stage I patients and its general role in stage II patients needs to be investigated.Keywords: Laparoscopy; testicular neoplasms; retroperitoneal spaceTurkiye Klinikleri J Surg Med Sci 2007, 3(4):43-48
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