睾丸腫瘍における後腹膜リンパ節郭清術

Abstract

Eighteen cases of testicular tumor were treated in our department for two years from September 1972 to August 1974, and in fourteen cases bilateral radical transperitoneal lymphnode dissection was performed. One of these fourteen cases, however, was unsuccessful due to gross infiiltration of metastatic tumors into the peri-aortic tissues. From these case studies the following results were obtained: 1) Cases with positive findings in foot lymphangiography always showed positive metastasis, and among those with negative findings metastasis was occasionally positive. One important reason for these false negatives is that there are lymphnodes unable to reveal by means of foot lymphangiography, but are shown by means of testicular lymphangiography. 2) Retroperitoneal lymphnode dissection should be done bilaterally because metastasis from a testicular tumor may spread to the retroperitoneal lymphnodes of the opposite side. 3) The more infiltrative the testicular tumor the higher the rate of metastasis in cases of seminoma and malignant teratoma. 4) The serum alpha-fetopropein test was negative in patients with seminoma, and was positive in most of the patients with embryonal carcinoma or malignant teratoma. 5) The main complications after radical transperitoneal lymphnode dissection were the absence of seminal emission and ileus.