[Surgical therapy of germinal testicle tumors (author's transl)]

Surgical intervention in patients with germinal testicular tumors is performed to obtain the exact tumor histology and to define the stage of disease. This can be achieved by inguinal orchiectomy and retroperitoneal exploration. In cases without metastases, a modified retroperitoneal lymphadenectomy (LA) can reduce operative morbidity. With regard to the juvenile age of the patients, protection of ejaculation is of particular importance. If retroperitoneal lymph node metastases are present radical LA should be performed. In case of infiltration of ureters or kidney pedicles a coincident of nephrectomy becomes necessary. Palliative primary surgery should be avoided by exact preoperative diagnosis. In patients presenting with primary inoperable tumors chemotherapy should be instituted prior to surgery. A more radical treatment is necessary if residual tumor has to be removed in a second look operation or after chemotherapy, respectively. Resection of metastases is particularly indicated in cases with mediastinal or pulmonary spread.