Laparoscopic retroperitoneal lymph node dissection for nonseminomatous germ-cell tumors: current status.
We review the published literature regarding the technical feasibility, oncologic outcomes, morbidity, and cost-effectiveness of laparoscopic retroperitoneal lymph node dissection (LRPLND). With proof that it is feasible, several centers have become expert in LRPLND and morbidity appears to be less than that of open RPLND. As the technique improves, it is likely that LRPLND will become equally if not more cost-effective than conventional RPLND. However, the oncologic outcomes, while on par with open RPLND series, are difficult to attribute to successful LRPLND alone when nearly all patients with positive lymph nodes received chemotherapy postoperatively. Although uncertainties exist, LRPLND holds much future promise.
Hamilton
Robert J
RJ
Division of Urology, Department of Surgery, University of Toronto, University Health Network, Princess Margaret Hospital, Toronto, Ontario, Canada.
Finelli
Antonio
A
D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D005240:Feasibility Studies; D006801:Humans; D010535:Laparoscopy; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009017:Morbidity; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000453:epidemiology / Q000601:surgery*; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000453:epidemiology / Q000601:surgery*