Intricacies of retroperitoneal lymph node dissection for testis cancer.
Journal
Current opinion in urology
ISSN: 1473-6586
Titre abrégé: Curr Opin Urol
Pays: United States
ID NLM: 9200621
Informations de publication
Date de publication:
01 Jan 2022
01 Jan 2022
Historique:
pubmed:
27
10
2021
medline:
30
4
2022
entrez:
26
10
2021
Statut:
ppublish
Résumé
Retroperitoneal lymph node dissection (RPLND) and retroperitoneal tumor resection for germ cell cancer are complex operations requiring experience and expertise in surgical techniques necessary to achieve complete resection while minimizing morbidity. This article reviews the intricacies of RPLND for testis cancer. Surgical management of advanced testis cancer begins with an intimate understanding of retroperitoneal anatomy and the various techniques necessary to safely extirpate tumors. Preoperatively patients should undergo comprehensive counseling and obtain up-to-date imaging along with tumor markers to assist in surgical planning and evaluation of extraretroperitoneal (ERP) disease. Surgeons must be well versed in nerve-sparing techniques to maintain ejaculatory function. Newer techniques using a midline extraperitoneal technique minimizes morbidity and length of hospital stay. Special consideration should be given to the possibility of encountering ERP disease in advanced germ cell tumors, with management of these cases in tertiary care centers with multidisciplinary teams. The perioperative care of the testis cancer patient undergoing RPLND is complex. The goal is to achieve complete resection to render patients disease free while minimizing surgical and long-term morbidity. Advanced testis cancer patients should be managed at tertiary care facilities with surgical expertise and access to multidisciplinary care.
Identifiants
pubmed: 34698701
doi: 10.1097/MOU.0000000000000938
pii: 00042307-202201000-00005
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
24-30Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
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