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Clinical Analysis of Laparoscopic Radical Orchiectomy in the Treatment of Testicular Tumors |
HAN Hu, TIAN Long, LEI Hong-en, et al |
Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020 |
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Abstract 【Objective】 To assess the feasibility and outcomes of laparoscopic radical orchiectomy in the management of testicular tumor. 【Methods】 From October 2019 to September 2020, 7 patients with testicular tumor in our hospital were retrospectively analyzed. All patients successfully underwent laparoscopic radical orchiectomy under general anesthesia. The peritoneum was incised above the inner ring, the vas deferens and spermatic cord were ligated respectively, the spermatic cord was pulled out and the testis was removed, and the peritoneum incision was sutured. The operation time, hospital stay and complications were recorded. The levels of tumor markers including alpha fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH) were compared before and after operation. 【Results】 The average operation time of 7 young patients was (103.9±25.8) min, and the average length of stay was (6.6±1.9) d, intraoperative blood loss was (12.1±5.7)mL. According to Clavien Dindo evaluation, there were 2 cases of grade I postoperative complications, including 1 case of subcutaneous emphysema during operation, which subsided spontaneously on the second day after operation, 1 case of postoperative wound pain, which needed analgesic treatment, and no grade Ⅱ-Ⅴ complications were found. There were no postoperative complications such as wound infection, urinary tract infection, abdominal pain, inguinal hernia and intestinal obstruction. The average follow-up time was (6.1±4.7) months, no local tumor recurrence and distant metastasis. There was significant difference in HCG level before and after operation (P<0.05), but no significant difference in AFP and LDH level (P>0.05).【Conclusion】 Laparoscopic radical orchiectomy is technically feasible, safe, and effective.
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Received: 19 November 2020
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[1] ALBERS P, ALBRECHT W, ALGABA F, et al. Guidelines on testicular cancer: 2015 update[J].Eur Urol,2015, 68(6): 1054-1068. [2] Stephenson A, Eggener S E, Bass E B, et al. Diagnosis and treatment of early stage testicular cancer: AUA Guideline[J].J Urol,2019, 202(2): 272-281. [3] GHOREIFI A, DJALADAT H. Management of primary testicular tumor[J].Urol Clin North Am,2019, 46(3): 333-339. [4] NAVER L, KOCK J. Laparoscopic orchiectomy for cryptorchidism[J].J Laparoendosc Surg,1992, 2(5): 245-246. [5] ESPOSITO C, CARDONA R, CENTONZE A, et al. Impact of laparoscopy on the management of an unusual case of nonpalpable testis in an adult patient [J].Surg Endosc,2003, 17(8): 1324. [6] BANSAL D, COST N G, BEAN C M, et al. Pediatric urological laparoendoscopic single site surgery: single surgeon experience [J].J Pediatr Urol,2014, 10(6): 1170-1175. [7] MITROPOULOS D, ARTIBANI W, BIYANI C S, et al. Validation of the clavien-dindo grading system in urology by the European Association of Urology Guidelines Ad Hoc Panel[J].Eur Urol Focus,2018,4(4):608-613. [8] GOLDBERG H, KLAASSEN Z, CHANDRASEKAR T, et al. Germ cell testicular tumors-contemporary diagnosis, staging and management of localized and advanced disease[J].Urology,2019,125:8-19. [9] VETTERLEIN M W, SEISEN T, L?PPENBERG B, et al. Resident involvement in radical inguinal orchiectomy for testicular cancer does not adversely impact perioperative outcomes—a retrospective study[J].Urol Int,2017, 98(4): 472-477. [10] ASHDOWN D A, BODIWALA D, LIU S. Is high cord radical orchidectomy always necessary for testicular cancer? [J].Ann R Coll Surg Engl,2004, 86(4): 289-291. [11] YANG X F, LIU J L. Anatomy essentials for laparoscopic inguinal hernia repair[J].Ann Transl Med,2016, 4(19):372. |
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