Retroperitoneal lymph node dissection for germ cell tumour

Vy Tran, Luke Gibson, Shomik Sengupta

Research output: Contribution to journalReview ArticleResearchpeer-review

6 Citations (Scopus)

Abstract

Retroperitoneal lymph node dissection (RPLND) is an infrequently used, but important part of the management of men with metastatic germ cell tumours. The surgery aims to remove the lymph nodes from the primary retroperitoneal landing site from testicular tumours, usually accomplished by removing tissue surrounding the great vessels using a split-and-roll technique. RPLND may be carried out as a primary surgical procedure for staging or treatment of metastases. More frequently it is undertaken as a follow-up after chemotherapy for a residual mass that may contain viable tumour or teratoma. RPLND is recognised as a major surgery with significant risks of morbidity and complications, particularly loss of ejaculation secondary to damage to hypogastric nerves. In select cases, especially during primary RPLND, nerve-sparing surgery may help preserve ejaculation, which maybe of importance to the young men usually treated for germ cell tumours. In recent years, the development of minimally invasive approaches have also offered a means for potential improvement in the pain and post-operative recovery from RPLND. We conducted a narrative review of the literature to assess indications for RPLND, along with operative approaches and techniques and related outcomes. The majority of available literature is in the form of relatively small retrospective case series, hence additional research in this area is desirable.

Original languageEnglish
Pages (from-to)3103-3111
Number of pages9
JournalTranslational Andrology and Urology
Volume9
Issue number6
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Germ cell tumour
  • Retroperitoneal lymph node dissection (RPLND)
  • Surgery
  • Testicular cancer

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