ABSTRACT

Testis cancer is not only sensitive to chemotherapy, but also to surgery. Several surgical approaches exist in the treatment of testicular cancer. These approaches include radical orchiectomy, retroperitoneal lymph node dissection (RPLND), post-chemotherapy RPLND, and non-retroperitoneal residual mass resection. These surgical procedures are associated with a variety of potential complications. Radical orchiectomy has minimal morbidity and no mortality. RPLND is associated with negligible mortality and minimal morbidity rates when performed by experienced surgeons. Postchemotherapy RPLND is a challenging operation because of the complexity of the procedure and the severe desmoplastic reaction from prior exposure to chemotherapeutic agents. Additionally, this operation is more extensive and some of these patients undergo additional resection of adjacent organs that are involved with disease. Therefore, post-chemotherapy RPLND has been associated with higher morbidity compared to the primary RPLND. On the occasion of post-chemotherapy RPLND is one of the most difficult and dangerous operations undertaken by urologists, it should be performed by experienced surgeons in referral centers.