Surgical Complications in Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminoma Germ Cell Tumour: A Population-based Study from the Swedish Norwegian Testicular Cancer Group
| Autor: | Axel Gerdtsson, Kristine Engen Andreassen, Rolf Wahlqvist, Dag Halvorsen, Gabriella Cohn-Cedermark, Torgrim Tandstad, Signe Melsen Larsen, George Jancke, Anders Kjellman, Hege Sagstuen Haugnes, Olof Ståhl, Magnus Törnblom, Göran Holmberg, Helene F. S. Negaard, Ulf Håkansson, Ingrid Glimelius, Ása Karlsdóttir |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Retrograde ejaculation
Adult Male medicine.medical_specialty Urology medicine.medical_treatment Population 030232 urology & nephrology 03 medical and health sciences Retroperitoneal lymph node dissection Young Adult 0302 clinical medicine Postoperative Complications Testicular Neoplasms medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Retroperitoneal Space education Intraoperative Complications Lymph node Testicular cancer Sweden education.field_of_study business.industry Norway Perioperative Neoplasms Germ Cell and Embryonal medicine.disease Surgery medicine.anatomical_structure Lymphatic system Oncology 030220 oncology & carcinogenesis Lymph Node Excision business Complication |
| Zdroj: | European Urology Oncology (EUO) |
| Popis: | Background Reports on perioperative complications after postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for nonseminoma germ cell tumour (NSGCT) are from experienced single centres, with a lack of population-based studies. Objective To assess the complications of bilateral and unilateral PC-RPLND. Design, setting, and participants A prospective, population-based, observational multicentre study included all patients with NSGCT who underwent PC-RPLND in Norway and Sweden during 2007–2014. Of a total of 318 patients, 87 underwent bilateral PC-RPLND and 231 underwent unilateral PC-RPLND. The median follow-up was 6 yr. Outcome measurements and statistical analysis Bilateral and unilateral PC-RPLND were compared for the outcomes of intra- and postoperative complications (graded by Clavien-Dindo) and retrograde ejaculation (with or without nerve-sparing surgery). Complications were reported as absolute counts and percentages. The χ2 test was used for comparisons. Results and limitations The incidence of intraoperative complications was higher for bilateral PC-RPLND than for unilateral PC-RPLND (14% vs 4.3%, p = 0.003), with ureteral injury as the most frequent reported complication (2% of the patients). Postoperative complications were more common after bilateral than after unilateral PC-RPLND (45% vs 25%, p = 0.001) with Clavien ≥3b reported in 8.3% and 2.2%, respectively (p = 0.009). Lymphatic leakage was the most common complication occurring in 11% of the patients. Retrograde ejaculation occurred more frequently after bilateral than after unilateral surgery (59% vs 32%, p |
| Databáze: | OpenAIRE |
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