Morbidity of open retroperitoneal lymph node dissection for testicular cancer: contemporary perioperative data
Morbidity of open retroperitoneal lymph node dissection for testicular cancer: contemporary perioperative data
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DOI：
10.1111/j.1464-410x.2009.08888.x
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发表时间：
2010-04-01
影响因子：
4.5
通讯作者：
Richie, Jerome P.
中科院分区：
文献类型：
--
作者：
Williams, Stephen B.;McDermott, David W.;Richie, Jerome P.
目的探讨原发性腹膜后淋巴结清扫术（P-RPLND）与化疗后RPLND的区别（PC-RPLND）在当代睾丸癌患者系列中的应用，以验证所提出的低发病率。患者和方法2001-2008年在我们机构接受RPLND的患者被确定，他们的临床图表被回顾;在190名患有RPLND的患者中，分别有98名（52%）和92名（48%）患有P-和PC-RPLND。子宫颈切除术标本的组织学包括146例（76%）胚胎癌，83例（44%）还包括淋巴管浸润。平均（范围）手术持续时间为206（110-475）min，平均失血量为294（50-7000）mL。平均住院时间为4天。P-RPLND组的平均失血量、手术时间和住院时间均显著少于PC-RPLND组（P < 0.05）。共发生18例（9%）围手术期并发症。两组均无死亡病例。CONCLUSIONSThe短期发病率的开放RPLND是可以接受的，开放RPLND是安全和有效的，在选择三级中心。与历史数据相比，目前的当代系列显示手术时间、失血量和住院时间有所改善，并发症很少。在比较腹腔镜与开放性RPLND时，应考虑这些当代数据。
OBJECTIVETo review differences between primary retroperitoneal lymph node dissection (P-RPLND) and RPLND after chemotherapy (PC-RPLND) in a contemporary series of patients with testicular cancer, to validate the proposed low morbidity.PATIENTS AND METHODSPatients who had undergone RPLND at our institution in 2001-2008 were identified and their clinical charts reviewed; in all, 190 were identified and perioperative data obtained.RESULTSOf the 190 patients who had RPLND, 98 (52%) and 92 (48%) had P- and PC-RPLND, respectively. Histology of the orchidectomy specimen consisted of embryonal carcinoma in 146 (76%) patients, also including lymphovascular invasion in 83 (44%). The mean (range) operative duration was 206 (110-475) min and the mean blood loss was 294 (50-7000) mL. The median hospital stay was 4 days. Mean blood loss, operative duration and hospital stay were significantly less for the P-RPLND than for PC-RPLND groups (P < 0.05). There were 18 (9%) perioperative complications in all. There were no deaths in either group.CONCLUSIONSThe short-term morbidity of open RPLND is acceptable, and open RPLND is safe and effective at select tertiary centres. When compared with historical data, the present contemporary series shows that the operative duration, blood loss and hospital stay have improved, with few complications. These contemporary data should be considered when comparing laparoscopic with open RPLND.