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Retroperitoneale Lymphadenektomie bei Hodentumoren

Indikationen zur Laparoskopie

Retroperitoneal lymph node dissection for testicular cancer

Indications for laparoscopy

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Der Onkologe Aims and scope

Zusammenfassung

Vorrangige Indikation zur retroperitonealen Lymphadenektomie (RLA) beim Hodentumor ist die Residualtumorresektion. Als primäre Maßnahme in den klinischen Stadien I und IIA/B beim Nichtseminom ist die Operation heute kaum noch von Bedeutung. Gerade für letztgenannte Indikationen wäre alternativ zum offenen Vorgehen die Laparoskopie geeignet, während sie bei der Residualtumorresektion nur für kleine Restbefunde in Frage kommt. Die onkologischen Langzeitergebnisse sind mit denen der offenen Operation vergleichbar, auch ist ein nervschonendes Vorgehen möglich, vorausgesetzt, es handelt sich um einen laparoskopisch versierten Operateur.

Abstract

The strongest indication to perform retroperitoneal lymph node dissection (RPLND) in testicular cancer is for removal of residual disease after chemotherapy in advanced nonseminoma. As a primary option for stage I or small volume metastatic nonseminoma RPLND has lost its importance today. Nevertheless, especially these are the stages where surgery can be performed laparoscopically, while in cases of residual tumor resection only small residuals can be removed with this technique. The oncological long-term results of laparoscopic RPLND are comparable to open surgery; nerve sparing is possible, provided that the surgeon has sufficient experience with laparoscopy. RPLND is not an operation to learn laparoscopy.

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Authors and Affiliations

  1. Klinik für Urologie, Medizinische Hochschule Hannover, Hannover, Deutschland

    M. Kuczyk

  2. Klinik für Urologie, Krankenhaus Maria Hilf, Oberdießemerstraße 94, 47805, Krefeld, Deutschland

    S. Krege

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  1. M. Kuczyk
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  2. S. Krege
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Correspondence to S. Krege.

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Kuczyk, M., Krege, S. Retroperitoneale Lymphadenektomie bei Hodentumoren. Onkologe 14, 587–592 (2008). https://doi.org/10.1007/s00761-008-1360-y

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