Role of Retroperitoneal Lymph Node Dissection in the Management of Testicular Cancer

BACKGROUND: Retroperitoneal lymph node dissection is an important component of staging and management of nonseminomatous germ-cell carcinoma of the testis. Ejaculatory impotence has been a dominant aspect of operative morbidity. METHODS: The author has led the investigation of a series of modifications of operative techniques with the aim of reducing morbidity while retaining the prognostic and therapeutic benefits for retroperitoneal lymph node dissection. RESULTS: The advances in surgical techniques have reduced the incidence of ejaculatory impotence to less then 5%. Guidelines for the type of retroperitoneal lymph node dissection for different clinical stages of disease are presented. CONCLUSIONS: The advances in surgical techniques for retroperitoneal node dissection have minimized morbidity. The procedure plays a role in many clinical stages of testicular cancer.