title: Laparoscopic retroperitoneal lymph node dissection for testicular cancer.
abstract: OBJECTIVE
  Laparoscopic retroperitoneal lymph node dissection (L-RPLND) was introduced over 20 years ago as a less invasive alternative to open node dissection. In this review we summarise the indications, surgical technique and outcomes of L-RPLND in the treatment of testicular cancer.
  
  
  METHODS
  We searched MEDLINE using the terms 'laparoscopy', 'laparoscopic', 'retroperitoneal lymph node dissection', 'RPLND' and 'testicular neoplasms'. Articles were selected on the basis of their relevance, study design and content, with an emphasis on more recent data.
  
  
  RESULTS
  We found 14 pertinent studies, which included >1300 patients who received either L-RPLND (515) or open RPLND (788). L-RPLND was associated with longer mean operative times (204 vs. 186 min), but shorter hospital stays (3.3 vs. 6.6 days) and lower complication rates (15.6% vs. 33%). Oncological outcomes were similar between L-RPLND and open RPLND, with local relapse rates of 1.3% and 1.4%, incidence of distal progression of 3.3% and 6.1%, biochemical failure in 0.9% and 1.1% and cure rates of 100% and 99.6%, respectively.
  
  
  CONCLUSIONS
  There are no randomised controlled studies comparing L-RPLND with open RPLND. A review of case and comparative series showed similar perioperative and oncological outcomes. Patients undergoing L-RPLND on average have shorter hospital stays, a quicker return to normal activity and improved cosmesis.
authors.affiliation: The Arthur Smith Institute for Urology, Lake Success, NY, USA.
authors.forename: Joel H
authors.initials: JH
authors.lastname: Hillelsohn
authors.affiliation: The Arthur Smith Institute for Urology, Lake Success, NY, USA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Duty
authors.affiliation: The Arthur Smith Institute for Urology, Lake Success, NY, USA.
authors.forename: Zhamshid
authors.initials: Z
authors.lastname: Okhunov
authors.affiliation: The Arthur Smith Institute for Urology, Lake Success, NY, USA.
authors.forename: Louis R
authors.initials: LR
authors.lastname: Kavoussi
keywords: (L-)RPLND, (laparoscopic-) retroperitoneal lymph node dissection; (N)(S)GCT, (non) (seminomatous) germ cell tumour; Germ cell tumour; IMA, inferior mesenteric artery; IVC, inferior vena cava; LOS, length of hospital stay; Laparoscopy; Lymph node dissection; Retroperitoneal; SC, spermatic cord; Testicular cancer