Complications of primary retroperitoneal lymph-node dissection for low-stage testicular cancer

The surgical complications encountered in 478 patients who underwent primary retroperitoneal lymph-node dissection for clinical stage A and B nonseminomatous testicular cancer during the period ranging from 1982 to 1992 were reviewed. There were 54 complications in 51 patients (10.6%), and there was no surgery-related mortality. There were 16 minor complications and 38 major complications. The most frequent complication encountered was superficial wound infection, and many of the major complications were related to small-bowel obstruction and atelectasis. The incidence of complications was significantly lower in patients operated on during the last 6 years of the study (1987-1992). The complication rate was lower in patients who underwent modified unilateral procedures than in those who had bilateral dissections. The ejaculation rate of patients undergoing nerve-sparing procedures was 98%. This study reinforces the conclusion that primary retroperitoneal lymph-node dissection is an operation yielding minimal morbidity and no long-standing effect.