Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer.

Purpose: To report the long-term oncologic outcome and morbidity of laparoscopic retroperitoneal lymph-node dissection (L-RPLND) in clinical stage I nonseminomatous testicular germ-cell tumors (NSGCT) from a single institution. Patients and Methods: From August 1992 to May 2005, 136 patients with clinical stage I disease underwent L-RPLND. The mean follow-up was 68 months (range 8–151 months). Patient selection was not based on histologic findings or the presence of risk factors. Lymphadenectomy was performed within the boundaries described by Weissbach and Boedefeld. Results: The laparoscopic procedure could be completed in 129 patients (94.9%). Seven required conversion to open surgery. The median blood loss was 50 mL (range 20–3000 mL), and the mean operative time was 261 minutes (range 115–570 minutes). There were no perioperative deaths. The mean postoperative hospital stay was 4.1 days. Antegrade ejaculation was preserved in all patients. In the series, 25 patients (18.4%) had pathologic stage IIA d...