[Do retroperitoneal vascular abnormalities influence the operability of metastasizing testicular tumors?]

The lymphatic drainage of the testis is closely related topographically to the large retroperitoneal vessels. In retroperitoneal lymphadenectomy (RLA), the surgeon therefore takes the vessel topography as his point of orientation. Typical vascular findings, deviated from the norm, of altogether 285 lymphadenectomies (Jan. 1966-Dec. 1980) are described. The vascular variations do not influence the radicality of the operation. Knowledge of these variations help to prevent vascular lesions. On the other hand, infiltrations of larger vessels entail an extension of the operation. Involvement of the renal vessels (walling in, infiltration) may necessitate nephrectomy. Infiltrations of the wall of the aorta, vena cava or the pelvic vessels are resected and sutured according to the rules of vascular surgery. Involvement of infrarenal and unilateral renal vessels may not be allowed to impede radical extirpation of the tumor.