COMPLICATIONS OF PRIMARY RETROPERITONEAL LYMPH-NODE DISSECTION FOR LOW-STAGE TESTICULAR CANCER

The surgical complications encountered in 478 patients who underwent p rimary retroperitoneal lymphnode dissection for clinical stage A and B nonseminomatous testicular cancer during the period ranging from 1982 to 1992 were reviewed. There were 54 complications in 51 patients (10 .6%), and there was no surgery-related mortality. There were 16 minor complications and 38 major complications. The most frequent complicati on encountered was superficial wound infection, and many of the major complications were related to small-bowel obstruction and atelectasis. The incidence of complications was significantly lower in patients op erated on during the last 6 years of the study (1987-1992). The compli cation rate was lower in patients who underwent modified unilateral pr ocedures than in those who had bilateral dissections. The ejaculation rate of patients undergoing nervesparing procedures was 98%. This stud y reinforces the conclusion that primary retroperitoneal lymph-node di ssection is an operation yielding minimal morbidity and no long-standi ng effect.