Additional surgical procedures and perioperative morbidity in post-chemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer in two intermediate volume hospitals
| Autor: | Axel Bex, Henk G. van der Poel, Simon Horenblas, J.L.H. Ruud Bosch, Joost M. Blok, Jeanette van Vooren, Japke J van Urk, Richard P. Meijer |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Nephrology medicine.medical_specialty Additional Surgical Procedure Urology medicine.medical_treatment 030232 urology & nephrology Retroperitoneal lymph node dissection Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Testicular Neoplasms Testicular cancer Internal medicine medicine Humans Retroperitoneal Space Retrospective Studies business.industry Postoperative complication Perioperative medicine.disease Hospitals Surgery Lymphatic Metastasis 030220 oncology & carcinogenesis Testicular germ cell tumor Lymph Node Excision Original Article Teratoma Morbidity Complication business |
| Zdroj: | World Journal of Urology |
| ISSN: | 1433-8726 0724-4983 |
| DOI: | 10.1007/s00345-020-03229-5 |
| Popis: | Purpose To evaluate the perioperative morbidity of PC-RPLND in two intermediate volume centers and to identify predictors of high morbidity. Methods Retrospective analysis of 124 patients treated with open PC-RPLND at two tertiary referral centers between 2001 and 2018. Perioperative morbidity was determined by analyzing additional surgical procedures, intra-operative blood loss, and postoperative complications. Results An additional procedure was necessary for 33 patients (26.6%). The risk was higher in patients with IGCCCG intermediate/poor prognosis (OR 3.56; 95% CI 1.33–9.52) and residual tumor size > 5 cm (OR 3.53; 95% CI 1.39–8.93). Blood loss was higher in patients with IGCCCG intermediate/poor prognosis (β = 0.177; p = 0.029), large residual tumor (β = 0.570; p β = 0.342; p β = − 0.19; p = 0.014). Thirty-one patients had a postoperative complication Clavien-Dindo Grade ≥ 2 (25.0%). Complication risk was highest in patients undergoing an additional intervention (OR 3.46; 95% CI 1.03–11.60; p = 0.044). Conclusions The rate of additional interventions in our series is comparable to what has been reported in high-volume centers. IGCCCG intermediate/poor prognosis patients with high-volume disease and patients undergoing an additional surgical procedure can be classified as high-risk patients. |
| Databáze: | OpenAIRE |
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