Mp50-07 contemporary short-term outcomes for open virgin retroperitoneal lymph node dissection

You have accessJournal of UrologyCME1 Apr 2023MP50-07 CONTEMPORARY SHORT-TERM OUTCOMES FOR OPEN VIRGIN RETROPERITONEAL LYMPH NODE DISSECTION Jacob Mcfadden, Timothy Masterson, and Clint Cary Jacob McfaddenJacob Mcfadden More articles by this author , Timothy MastersonTimothy Masterson More articles by this author , and Clint CaryClint Cary More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003298.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Retroperitoneal lymph node dissection (RPLND) remains an important therapeutic option for select men with clinical stage I and clinical stage II testicular cancer. Refinement of the open surgical technique has led to improved outcomes and morbidity profiles for this procedure over the past two decades. As techniques continue to evolve in hopes of improving surgical morbidity, contemporary reporting of the current standard of care is increasingly important. Thus, we report current perioperative outcomes and short-term complication rates for open virgin retroperitoneal lymph node dissection (O-VRPLND), with analysis of risk factors for complications in a consecutive single-institution series. METHODS: The institutional Indiana University Testicular Cancer database was utilized to identify all patients that underwent O-VRPLND over the study period (2018-2020). Demographic, perioperative, and pathologic variables were collected. Retrospective chart review was performed. Short term complications were graded using the Clavien-Dindo classification. The primary outcomes of interest were the contemporary preoperative profile of patients undergoing O-VRPLND, overall complication rates, and identification of risk factors associated with any complication. RESULTS: During the study period 165 patients were identified. Median BMI was 28.6, with a median ASA III classification. The majority (63.6%) of patients underwent O-VRPLND for non-seminomatous germ cell tumors compared with 30.9% for seminomas; patients were most often clinical stage IIA (39%) or IIB (36%) at the time of surgery. Median estimated blood loss (EBL) was 150cc, with no transfusions required. Among all preoperative and intraoperative variables, only BMI demonstrated significant association with development of any postoperative complication (mean BMI of 34.46 for patients with any complication, versus 28.94 for patients with normal recovery; p=0.0042). Median hospital stay was 3 days. Overall complication rate was low (8.48%), with one major postoperative complication and no deaths in the 30-day period. CONCLUSIONS: Open virgin RPLND has an acceptable morbidity profile, even among a cohort of predominantly overweight young patients with high ASA scores. Low EBL, short hospital stay, low 30-day readmission rate, and rare major postoperative complications may reflect the new benchmark for virgin RPLND. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e687 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jacob Mcfadden More articles by this author Timothy Masterson More articles by this author Clint Cary More articles by this author Expand All Advertisement PDF downloadLoading ...