UroToday.com - Ours is a retrospective review of patients who underwent open retroperitoneal lymph node dissection between 2001-2008.

We identified perioperative data for patients who underwent primary (P-RPLND) versus post-chemotherapy RPLND (PC-RPLND) and found mean blood loss, operative duration and hospital stay to be significantly less for the former group (P<0.05). A majority of the patients had high risk features at orchiectomy consisting of 146 (76%) embryonal carcinoma and 83 (44%) having lymphovascular invasion. Not surprisingly, more clinical stage I (CS I) patients underwent primary versus PC-RPLND (55% vs. 38%) and the converse for clinical stage II (CSII) disease (45% vs. 62%). Overall, there were 18 (9%) complications with 7 (7%) and 11 (12%) in the primary and PC-RPLND groups, respectively. All of these complications consisted pain, ileus, and chylous ascites except one patient who had an intraoperative aortic injury. There were no peri-operative deaths.

This contemporary data should be considered when comparing open versus laparoscopic RPLND (L-RPLND). Although L-RPLND has become an established alternative for management of CS I patients, more research is needed in patients with high-risk features and/or post-chemotherapy treated patients. The minimal morbidity of patients undergoing open RPLND by a dedicated tertiary center has been described in this contemporary group of patients and should be considered when comparing open to L-RPLND.

Written by Stephen B. Williams, MD, et al. as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations, etc., of their research by referencing the published abstract.

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