[Retroperitoneal laparoscopic lymphadenectomy for stage I non seminomatous testicular cancer].

Objectives: We report a series of patients with stage I non seminomatous testicular cancer in whom laparoscopic retroperitoneal lymphadenectomy was carried out.

Methods: Between March 1993 and January 2004 100 and patients with the diagnosis of stage I non seminomatous testicular cancer underwent laparoscopic retroperitoneal lymphadenectomy (LRPL). All operations were performed by the same surgeon (O.A.C). Clinical data were collected prospectively in a database. Patients' demographic data, operative time, estimated blood loss, hospital stay, operative and post operative complications, convention rate and follow-up were all analyzed.

Results: 111 LRPL were performed in 111 patients with a mean age of 29.3 years (range 15-44 years). 61 procedures were right-LRPL and 50 left-LRPL. Mean operative time was 138 minutes (range 60-300 minutes). Introoperative complications appeared in 10 cases (9%), 9 vascular complications (8.1%) and 1 duodenal lesion (0.9%). Conversion to open surgery was necessary in three patients (2.7%). Mean hospital stay was 43.3 hours (range 24-120). 5 patients (4.5%) had tumor recurrence, with a mean follow-up of 30 months (range 24-94 months). Recurrences were localized in the retroperitoneum, mediastinum and lungs. Recurrence time varied between four and 64 months.

Conclusions: LRPL offers oncological results equivalent to open surgery, with the advantage of being minimally invasive and its consequent decrease in morbidity. The laparoscopic retroperitoneal lymphadenectomy is a good option for the management of patients with stage 1 testicular cancer.