[Laparoscopic lumbo-aortic lymphadenectomy in early-stage non-seminomatous germ cell tumors of the testis: Why? How?].
OBJECTIVE
Laparoscopic lumbo-aortic lymphadenectomy is proposed in order to decrease the morbidity of pretreatment lymph node dissections for early stage NSGCT of the testis. Two approaches are presented and compared retrospectively: the transperitoneal approach and the extraperitoneal approach.


METHODS
From 1991 to 1999, 57 patients with clinical stage I (50) to IIA (7) NSGCT underwent pretreatment laparoscopic investigation of the para-aortic lymph nodes: 32 transumbilical transperitoneal dissections and 25 internal iliac extraperitoneal dissections were performed.


RESULTS
Only the 19 patients with lymph node invasion received chemotherapy. All serious complications occurred in the transperitoneal group: 1 case of chylous ascites and 2 cases of transient neurological complications, 2 cases of permanent ejaculation failure and 2 extranodal recurrences among the 38 pN0 patients.


CONCLUSIONS
Laparoscopy, especially extraperitoneal, appears to be a safe, effective and appropriate modality for pretreatment lumbo-aortic lymph node evaluation in early stage NSGCT of the testis.
Leblanc
E
E
Service de Cancérologie uro-digestive, Centre Osdcar Lambret, Lille, France. e-leblanc@o-lambret.fr
Caty
A
A
Dargent
D
D
Querleu
D
D
Mazeman
E
E
D000328:Adult; D018237:Germinoma / Q000556:secondary / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery*