title: Laparoscopic lumbar-aortic lymphadenectomy in residual post-chemotherapy tumours in testicular cancer.
abstract: BACKGROUND
  Open lumbar-aortic lymphadenectomy (OLAL) is the gold standard for treating post-chemotherapy retroperitoneal masses. Laparoscopic OLAL (L-OLAL) has emerged in recent years as an alternative for the handling of patients with these masses, with the additional potential benefits of minimal invasion.
  
  
  OBJECTIVE
  To present our experience with the laparoscopic handling (L-OLAL) of residual post-chemotherapy masses in patients with advanced testicular cancer.
  
  
  METHODS
  Between 1993 and 2009, 43 patients underwent post-chemotherapy L-OLAL. A transperitoneal technique was employed in all patients. We assessed demographic, perioperational and pathological variables, as well as complications and follow-up.
  
  
  RESULTS
  A unilateral dissection was performed in 17 patients, while 26 patients underwent a bilateral retroperitoneal dissection. In the first group, 4 patients relapsed. In the second group, there were no relapses. After an average follow-up of 21 months, the overall survival rate reached 95%. We recorded a rate of perioperative complications of only 9.3%.
  
  
  CONCLUSIONS
  In experienced hands, L-OLAL is a technically feasible surgical alternative for the treatment of patients who are carriers of advanced testicular cancer with residual post-chemotherapy masses. The dissection performed should be bilateral to avoid tumour relapses and increase the survival rate of these patients.
authors: Departamento de Urología, Clínica Indisa, Santiago, Chile; Facultad de Medicina, Universidad Andrés Bello, Santiago, Chile. Electronic address: octavio.castillo@indisa.cl.
authors: O A
authors: OA
authors: Castillo
authors: E
authors: E
authors: Landerer
authors: I
authors: I
authors: Vidal-Mora
mesh_terms: D000293:Adolescent; D000328:Adult; D001012:Aorta, Abdominal; D002648:Child; D002675:Child, Preschool; D006801:Humans; D010535:Laparoscopy; D008161:Lumbosacral Region; D008197:Lymph Node Excision / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011446:Prospective Studies; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D055815:Young Adult
keywords: Cáncer testicular; Laparoscopia; Laparoscopy; Linfadenectomía lumboaórtica; Lumbar-aortic lymphadenectomy; Masa retroperitoneal; Retroperitoneal mass; Testicular cancer