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Complications of nerve sparing retroperitoneal lymph node dissection
1National Centre of Urology, Tbilisi, Georgia.
Abstract:
Nerve sparing retroperitoneal lymph node dissection is standard treatment method for early stage non-seminomatous germ cell tumor. However, an alternative approaches (surveillance policy, adjuvant and primary chemotherapy) have approximately the same capability for cure. Therefore, the current debate is to decide which is less morbid for the patient at risk. We assessed associated complications of nerve sparing retroperitoneal lymph node dissection in 33 patients (25 with clinical stage I and 8 with clinical stage IIA) treated at our center from June 1996 to November 2005. There were 7 (21%) complications (2 intraoperative, 4 early minor and 1 early major) in 6 out of the 33 operated patients. There were no late complications. Antegrade ejaculation was preserved in 30 patients (91%). Postoperatively 19 out of 33 patients were classified as pathological stage I and 14 as pathological stage IIA. Both groups were balanced with respect to distribution of complications. The data indicate that nerve sparing RPLND is a well tolerated urologic procedure with a low early and no late morbidity.
Insights
Nerve sparing retroperitoneal lymph node dissection (RPLND) for early-stage non-seminomatous germ cell tumors is a safe procedure. This study found low early complication rates and no late complications, preserving antegrade ejaculation in most patients.
Area of Science:
- Urology
- Surgical Oncology
Background:
- Nerve sparing retroperitoneal lymph node dissection (RPLND) is standard for early-stage non-seminomatous germ cell tumors.
- Alternative treatments like surveillance and chemotherapy offer similar cure rates, prompting debate on minimizing patient morbidity.
Purpose of the Study:
- To assess the complications associated with nerve sparing RPLND.
- To evaluate the morbidity of this urologic procedure in patients with early-stage germ cell tumors.
Main Methods:
- Retrospective analysis of 33 patients undergoing nerve sparing RPLND between June 1996 and November 2005.
- Complications were categorized as intraoperative, early minor, early major, and late.
Main Results:
- A total of 7 complications (21%) occurred in 6 patients: 2 intraoperative, 4 early minor, and 1 early major.
- No late complications were observed.
- Antegrade ejaculation was preserved in 30 patients (91%).
Conclusions:
- Nerve sparing RPLND is a well-tolerated urologic procedure for germ cell tumors.
- The procedure demonstrates low early morbidity and no late complications, making it a favorable treatment option.
