Laparoscopic retroperitoneal lymph node dissection versus open retroperitoneal lymph node dissection for testicular cancer: A comparison of clinical and perioperative outcomes

Toshihide Shishido; Takatsugu Okegawa; Kenjiro Hayashi; Kazuki Masuda; Satoru Taguchi; Yu Nakamura; Mitsuhiro Tambo; Hiroshi Fukuhara

doi:10.1016/j.ajur.2021.05.004

Laparoscopic retroperitoneal lymph node dissection versus open retroperitoneal lymph node dissection for testicular cancer: A comparison of clinical and perioperative outcomes

Asian J Urol. 2022 Apr;9(2):119-124. doi: 10.1016/j.ajur.2021.05.004. Epub 2021 May 25.

Authors

Toshihide Shishido^{1

2}, Takatsugu Okegawa², Kenjiro Hayashi^{1

2}, Kazuki Masuda², Satoru Taguchi², Yu Nakamura², Mitsuhiro Tambo², Hiroshi Fukuhara²

Affiliations

¹ Department of Urology, Hachioji Medical Center, Tokyo Medical University, 1163, Tatemachi, Hachioji, Tokyo, Japan.
² Department of Urology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, Japan.

Abstract

Objective: This study was performed to evaluate the clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) and open retroperitoneal lymph node dissection (O-RPLND) performed by one surgeon at a single center.

Methods: We evaluated 30 patients with stage IIA germ cell tumors who underwent retroperitoneal lymph node dissection (15 underwent L-RPLND and 15 underwent O-RPLND) at our institution between April 1, 2010 and March 31, 2018. The clinical parameters were compared between patients who underwent L-RPLND using the retroperitoneal approach and those who underwent O-RPLND using the transperitoneal approach. There were no significant differences in the background characteristics of the two groups except for the median follow-up duration (46 months for L-RPLND and 71 months for O-RPLND, p=0.02).

Results: L-RPLND was associated with a shorter mean operative time (mean 222 min for L-RPLND vs. 453 min for O-RPLND, p<0.001). There was significantly less blood loss during surgery in the L-RPLND group compared to the O-RPLND group (mean 165 mL for L-RPLND vs. 403 mL for O-RPLND, p<0.001). Parameters related to postoperative recovery were significantly better for the L-RPLND group than for the O-RPLND group. There were no differences in the histopathological characteristics between the two groups. No patients in either group exhibited disease recurrence.

Conclusion: Patients who underwent L-RPLND had more rapid recovery, and shorter hospital stay compared to those who underwent O-RPLND; complications were comparable between the two groups. L-RPLND is an efficient procedure with the benefits of minimally invasive surgery.

Keywords: Laparoscopic surgery; Retroperitoneal lymph node dissection; Testicular tumor.