PURPOSE: We defined the blood loss, operative time and short-term morbidity of primary retroperitoneal lymph node dissection in a contemporary series to assess whether laparoscopic retroperitoneal lymph node dissection actually confers the magnitude of benefit claimed. MATERIALS AND METHODS: A retrospective chart review was performed of 75 consecutive patients who underwent primary retroperitoneal lymph node dissection during the 18 months ending May 2005. Two patients were excluded, including 1 who underwent right hemicolectomy for cecal adenocarcinoma and 1 with a pure seminomatous intra-abdominal testicle. RESULTS: Of the 73 patients 69 (94%) underwent unilateral dissection and 60 (82.2%) underwent a nerve sparing procedure. Mean operative time was 132 minutes (range 81 to 246) and mean blood loss was 207 cc (range 50 to 500). Nasogastric tubes were placed in 2 patients (2.7%). Mean time to start clear liquids was 1.0 day. Mean hospital stay was 2.8 days (range 2 to 4). CONCLUSIONS: The short-term morbidity of open retroperitoneal lymph node dissection, including operative time, blood loss and hospital stay, has significantly improved compared to historical controls. Perioperative management has changed with time. Comparing the morbidity of laparoscopic retroperitoneal lymph node dissection to that of historical controls is inappropriate.
PURPOSE: We defined the blood loss, operative time and short-term morbidity of primary retroperitoneal lymph node dissection in a contemporary series to assess whether laparoscopic retroperitoneal lymph node dissection actually confers the magnitude of benefit claimed. MATERIALS AND METHODS: A retrospective chart review was performed of 75 consecutive patients who underwent primary retroperitoneal lymph node dissection during the 18 months ending May 2005. Two patients were excluded, including 1 who underwent right hemicolectomy for cecal adenocarcinoma and 1 with a pure seminomatous intra-abdominal testicle. RESULTS: Of the 73 patients 69 (94%) underwent unilateral dissection and 60 (82.2%) underwent a nerve sparing procedure. Mean operative time was 132 minutes (range 81 to 246) and mean blood loss was 207 cc (range 50 to 500). Nasogastric tubes were placed in 2 patients (2.7%). Mean time to start clear liquids was 1.0 day. Mean hospital stay was 2.8 days (range 2 to 4). CONCLUSIONS: The short-term morbidity of open retroperitoneal lymph node dissection, including operative time, blood loss and hospital stay, has significantly improved compared to historical controls. Perioperative management has changed with time. Comparing the morbidity of laparoscopic retroperitoneal lymph node dissection to that of historical controls is inappropriate.
Authors: Nicholas R Rocco; Sean P Stroup; Haidar M Abdul-Muhsin; Michael T Marshall; Michael G Santomauro; Matthew S Christman; James O L'Esperance; Erik P Castle Journal: World J Urol Date: 2019-09-09 Impact factor: 4.226