[Lymphadenectomy for renal cell carcinoma]

The techniques, results and problems of lymphadenectomy were assessed in 56 cases of renal cell carcinoma. As the approach to the retroperitoneum, the thoracoabdominal approach was used in 22 cases and transabdominal approach in 34 cases. Radical nephrectomy was performed, followed by lymphadenectomy. All of the regional lymph nodes were dissected. The mean time required for lymphadenectomy was 1 hour and 40 minutes and the mean volume of blood loss was 350 ml. As intraoperative complications, vascular injury occurred in 3 cases. In 1 of these cases the left second lumbar vein was injured. Therefore, in lymphadenectomy caution should be exercised not to give injury to this blood vessel. The postoperative complication observed included bleeding and chylous ascites in 1 case each. In performing operations one must ligate the lymphatic vessel carefully. The 5-year-survival rate for 6 cases associated with metastasis to lymph node was 33%. From this fact, it was postulated that lymphadenectomy is helpful to improve prognosis of these patients.