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Jean-Baptiste ROCHE

Clinique Saint Augustin
Bordeaux, France
MD
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Laparoscopic right lymphadenectomy (R-LND) for non-seminomatous testis tumors
This video aims to demonstrate the right side of a laparoscopic technique for the treatment of non-seminomatous testicular germ cell tumors (NSGCT). A laparoscopic left lymphadenectomy (L-LND) was published last October 2012. This video shows the right side which could be reproduced laparoscopically at our urology center. A minimally invasive procedure such as this one can be performed with experience, resulting in a magnified anatomy provided by visual optics. Careful dissection of all vascular structures will provide full access to the templates described for lymph node dissections of this kind of tumor. It is essential to consider that treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference.
References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
JB Roche, VE Corona Montes, JL Hoepffner, T Piéchaud
Surgical intervention
6 years ago
3719 views
71 likes
0 comments
13:36
Laparoscopic right lymphadenectomy (R-LND) for non-seminomatous testis tumors
This video aims to demonstrate the right side of a laparoscopic technique for the treatment of non-seminomatous testicular germ cell tumors (NSGCT). A laparoscopic left lymphadenectomy (L-LND) was published last October 2012. This video shows the right side which could be reproduced laparoscopically at our urology center. A minimally invasive procedure such as this one can be performed with experience, resulting in a magnified anatomy provided by visual optics. Careful dissection of all vascular structures will provide full access to the templates described for lymph node dissections of this kind of tumor. It is essential to consider that treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference.
References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
Laparoscopic left lymphadenectomy (L-LND) for non-seminomatous testis tumors
This video demonstrates a laparoscopic technique for the treatment of clinical stage I non-seminomatous testicular germ cell tumors (NSGCT). Dissection could be reproduced laparoscopically at our urology center. The laparoscopic approach is a tool used for pathologic lymph node staging and laparoscopy has provided well-known and proven benefits (mean of hospital stay and bleeding), including minor intraoperative and postoperative complications. Currently, there are several options for clinical stage I NSGCT: surveillance, primary chemotherapy, open retroperitoneal lymph node dissection (RPLND) and laparoscopic retroperitoneal lymph node dissection (L-RPLND), and treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference goes to the procedure.

References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.
JL Hoepffner, JB Roche, VE Corona Montes, T Piéchaud
Surgical intervention
6 years ago
3256 views
51 likes
0 comments
10:37
Laparoscopic left lymphadenectomy (L-LND) for non-seminomatous testis tumors
This video demonstrates a laparoscopic technique for the treatment of clinical stage I non-seminomatous testicular germ cell tumors (NSGCT). Dissection could be reproduced laparoscopically at our urology center. The laparoscopic approach is a tool used for pathologic lymph node staging and laparoscopy has provided well-known and proven benefits (mean of hospital stay and bleeding), including minor intraoperative and postoperative complications. Currently, there are several options for clinical stage I NSGCT: surveillance, primary chemotherapy, open retroperitoneal lymph node dissection (RPLND) and laparoscopic retroperitoneal lymph node dissection (L-RPLND), and treatment will depend on some parameters such as histology, tumor markers, lymphovascular invasion, and in case surgery is decided upon, the patient’s preference goes to the procedure.

References
1. Valero Fuentealba G. [Antegrade ejaculation alter modified lumboaortic laparoscopic lymphadenectomy]. Arch Esp Urol 2008;61:517-20.

2. Castillo OA, Sánchez-Salas R, Secin FP, Campero JM, Foneron A, Vidal-Mora I. Linfadenectomía retroperitoneal laparoscópica primaria para el tumor testicular de células germinales no seminomatoso en estadio clínico I. Actas Urol Esp 2011;35:22-8.
3. Donohue JP, Thornhill JA, Foster RS, Rowland RG, Bihrle R. Primary retroperitoneal lymph node dissection in clinical stage A non-seminomatous germ cell testis cancer. Review of the Indiana University experience 1965-1989. Br J Urol 1993;71:326-35.
4. Yoon GH, Stein JP, Skinner DG. Retroperitoneal lymph node dissection in the treatment of low-stage nonseminomatous germ cell tumors of the testicle: an update. Urol Oncol 2005;23:168-77.

5. Carver BS, Sheinfeld J. The current status of laparoscopic retroperitoneal lymph node dissection for non-seminomatous germ-cell tumors. Nat Clin Pract Urol 2005;2:330-5.

6. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

7. Nelson JB, Chen RN, Bishoff JT, Oh WK, Kantoff PW, Donehower RC, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors. Urology 1999;54:1064-7.

8. Bhayani SB, Ong A, Oh WK, Kantoff PW, Kavoussi LR. Laparoscopic retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell testicular cancer: a long-term update. Urology 2003;62:324-7.

9. Donohue JP, Zachary JM, Maynard BR. Distribution of nodal metastases in nonseminomatous testis cancer. J Urol 1982;128:315-20.

10. Weissbach L, Boedefeld EA. Localization of solitary and multiple metastases in stage II nonseminomatous testis tumor as basis for a modified staging lymph node dissection in stage I. J Urol 1987;138:77-82.

11. Höltl L, Peschel R, Knapp R, Janetschek G, Steiner H, Hittmair A, Rogatsch H, Bartsch G, Hobisch A. Primary lymphatic metastatic spread in testicular cancer occurs ventral to the lumbar vessels. Urology 2002;59:114-8.

12. Chang SS, Mohseni HF, Leon A, Sheinfeld J. Paracolic recurrence: the importance of wide excision of the spermatic cord at retroperitoneal lymph node dissection. J Urol 2002;167:94-6.

13. Beck SD, Cheng L, Bihrle R, Donohue JP, Foster RS. Does the presence of extranodal extension in pathological stage B1 nonseminomatous germ cell tumor necessitate adjuvant chemotherapy? J Urol 2007;177:944-6.

14. Richie JP. Clinical stage I testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol 1990;144:1160-3.

14. Janetschek G, Peschel R, Hobisch A, Bartsch G. Laparoscopic retroperitoneal lymph node dissection. J Endourol 2001;15:449-53.

15. Albqami N, Janetschek G. Laparoscopic retroperitoneal lymph-node dissection in the management of clinical stage I and II testicular cancer. J Endourol 2005;19:683-92.

16. Poulakis V, Skriapas K, de Vries R, Dillenburg W, Ferakis N, Witzsch U, Becht E. Quality of life after laparoscopic and open retroperitoneal lymph node dissection in clinical Stage I nonseminomatous germ cell tumor: a comparison study. Urology 2006;68:154-60.

17. Abdel-Aziz KF, Anderson JK, Svatek R, Margulis V, Sagalowsky AI, Cadeddu JA. Laparoscopic and open retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testis tumors. J Endourol 2006;20:627-31.

18. Bhayani SB, Allaf ME, Kavoussi LR. Laparoscopic RPLND for clinical stage I nonseminomatous germ cell testicular cancer: current status. Urol Oncol 2004;22:145-8.

19. Eggener SE, Carver BS, Sharp DS, Motzer RJ, Bosl GJ, Sheinfeld J. Incidence of disease outside modified retroperitoneal lymph node dissection templates in clinical stage I or IIA nonseminomatous germ cell testicular cancer. J Urol 2007;177:937-42.

20. Nielsen ME, Lima G, Schaeffer EM, Porter J, Cadeddu JA, Tuerk I, Kavoussi LR. Oncologic efficacy of laparoscopic RPLND in treatment of clinical stage I nonseminomatous germ cell testicular cancer. Urology 2007;70:1168-72.

21. Valdevenito Sepulveda JP, Merhe Nieva E, Valdevenito Sepulveda R, Cuevas Toro M, Gómez Gallo A, Bermúdez Luna H, Contreras Meléndez L, Gallegos Méndez I, Gallardo Escobar J. Palma Ceppi C. [Reduced retroperitoneal lymphadenectomy for clinical stage I non seminomatous germ cell testicular cancer]. Arch Esp Urol 2007;60:245-54.

22. Neyer M, Peschel R, Akkad T, Springer-Stöhr B, Berger A, Bartsch G, Steiner H. Long-term results of laparoscopic retroperitoneal lymph-node dissection for clinical stage I nonseminomatous germ-cell testicular cancer. J Endourol 2007;21:180-3.