title: [Laparoendoscopic single-site retroperitoneal lymph node dissection: initial experience and 1-year follow-up].
abstract: OBJECTIVE
  To summarize our initial experience with laparoendoscopic single-site (LESS) retroperitoneal lymph node dissection (RPLND) for treatment of nonseminomatous testicular cancer.
  
  
  METHODS
  From September 2010 to June 2011, 3 patients (aged 19-27 years) with right testicle enlargement and elevated alpha-fetoprotein level underwent right radical orchidectomy. Histopathological analysis revealed nonseminomatous germ cell tumor. LESS-RPLND was performed 3 weeks after orchiectomy. The homemade port was inserted through a 3-cm right pararectal incision in the right lower quadrant for unilateral RPLND using nerve-sparing technique and modified right-sided template removal similar to those in open RPLND.
  
  
  RESULTS
  The operation was successfully performed with a mean operative time of 240 min and a mean estimated blood loss of 50 ml. No conversion to open or conventional laparoscopic surgery was required. No major perioperative complications were observed. For the first case, the number of lymph nodes obtained for final histopathological examination was 11, and two positive nodes were detected. For the other 2 cases, no positive nodes were detected. Chemotherapy was administered in the first case. Alpha-fetoprotein level decreased close to the baseline one week postoperatively and no relapse occurred in these cases 3 month after RPLND.  Follow-up at 1 year after the surgery showed good tumor control and preservation of the sexual function.
  
  
  CONCLUSIONS
  LESS-RPLND is safe and feasible for treatment of nonseminomatous testicular cancer, and the pararectal incision provides an ideal surgical approach with good cosmetic result, but the long-term effect needs to be tested by further large population-based study.
authors.affiliation: Department of Urology, Southern Medical University, Guangzhou, China.
authors.forename: Abai
authors.initials: A
authors.lastname: Xu
authors.forename: Hulin
authors.initials: H
authors.lastname: Li
authors.forename: Shaobo
authors.initials: S
authors.lastname: Zheng
authors.forename: Guoping
authors.initials: G
authors.lastname: Zhao
authors.forename: Haiyan
authors.initials: H
authors.lastname: Shen
authors.forename: Chunxiao
authors.initials: C
authors.lastname: Liu
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000601:surgery*; D009919:Orchiectomy; D012187:Retroperitoneal Space / Q000601:surgery*; D013736:Testicular Neoplasms / Q000601:surgery*; D055815:Young Adult