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タイトル: | Stage 2A 精巣胎児性癌に対して神経温存後腹膜リンパ腫郭清術を施行した1例 |
その他のタイトル: | Nerve-sparing retroperitoneal lymph node dissection for stage IIA testicular embryonal carcinoma: a case report |
著者: | 寺地, 敏郎 ![]() 荒井, 陽一 ![]() 前田, 純宏 ![]() 竹内, 秀雄 ![]() 吉田, 修 ![]() |
著者名の別形: | Terachi, Toshiro Arai, Yoichi Maeda, Sumihiro Takeuchi, Hideo Yoshida, Osamu |
キーワード: | Testicular tumor Stage IIA Nerve-sparing retroperitoneal lymph node dissection |
発行日: | Oct-1992 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 38 |
号: | 10 |
開始ページ: | 1191 |
終了ページ: | 1194 |
抄録: | A 32-year-old man who had left testicular embryonal carcinoma with low volume left para-aortic lymph node swelling was treated initially with 3 courses of cisplatin-based combination chemotherapy. Pathological findings of the primary lesion revealed no yolk sac element and no elevation of serum alpha fetoprotein (alpha-FP) and beta-human chorionic gonadotropin (beta-HCG) levels even before the left orchiectomy. Therefore, the retroperitoneal lymph node dissection (RPLND) was performed despite marked shrinkage of the enlarged nodes. The L1-3 lumber splanchnic nerves from the right sympathetic truncus were detected in the intra-aortocaval region to prevent impairment of ejaculatory function and the lymph nodes in the area were removed one by one between the preserved neurofibers. On the other hand, the left para-aortic lymphatic tissue which included enlarged nodes was dissected in en bloc manner. The pre-aortic lymphatic tissue caudally to the inferior mesenteric artery was preserved not to be touched. The patient ejaculated normally 3 weeks after the RPLND. Treatment of stage IIA disease with chemotherapy first might be helpful in performing RPLND, if necessary, with keeping both ejaculatory function and radicality. |
URI: | http://hdl.handle.net/2433/117665 |
PubMed ID: | 1481782 |
出現コレクション: | Vol.38 No.10 |
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