Laparoscopic unroofing of retroperitoneal lymphoceles after bilateral retroperitoneal lymphadenectomy for testicular cancer.
BACKGROUND
Symptomatic lymphoceles after retroperitoneal lymphadenectomy for testicular cancer are a rare complication that can be managed by either a computed tomography (CT)-guided subcutaneous aspiration or surgery. One surgical method of choice is laparoscopic unroofing.


METHODS
One case of two retroperitoneal lymphoceles managed by laparoscopy is presented. After successful creation of pneumoperitoneum, first trocar insertion, and lysis of adhesions, the two lymphoceles were unroofed, and specimens from the wall and fluid were taken.


RESULTS
Laparoscopic surgery was uneventful, and the patient returned to activity and work within 14 days after the operation. No pathologic signs of malignancy were discovered during biopsy and cytology investigations. At the 1-month follow-up assessment, CT scan demonstrated the regression, and 1 year later the total absence of the lymphoceles.


CONCLUSIONS
After retroperitoneal lymphadenectomy for testicular cancer, clinical suspicion should remain high to detect and properly treat symptomatic lymphoceles. Large retroperitoneal lymphoceles can be treated effectively by unroofing under the safe direct vision of the laparoscope.
Rózsahegyi
J
J
Departments of Urology and Andrology, Semmelweis University, 1135 Budapest, Szabolcs u. 35, Hungary. gamal@mail.hiete.hu
Gamal
E M
EM
Laki
A
A
Kovács
G
G
Kiss
J
J
D000328:Adult; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008210:Lymphocele / Q000209:etiology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D012186:Retroperitoneal Neoplasms / Q000209:etiology / Q000601:surgery*; D013736:Testicular Neoplasms / Q000601:surgery*; D016896:Treatment Outcome