Abstract：Objective:To investigate surgical techniques and clinical feasibility of a modified laparoscopic retroperitoneal lymph node dissectionMethods:Between July 2008 and May 2012, 21 patients with primary testicular nonseminomatous germ cell tumors (NSGCT) received extraperitoneal laparoscopic retroperitoneal lymph node dissection (EL-RLND) weeks after orchiectomy. The operating time, intraoperative blood loss, postoperative intestinal function, recovery time, hospital stay time, intra- operative and post-operative complications were recorded.Results:EL-RLND was successfully performed in 21 patients. One intra-operative complication was injury of the vena cave. Two post-operative complications were chylous ascites in one patient and ureteral obstruction in another patient. The mean operative time for the entire series was (153±73) minutes. The mean blood loss was (195±80) ml. The mean postoperative intestinal function recovery time was 2 days. The mean postoperative hospitalization was (4.5±2.7) days. No recurrence or distant metastasis occurred during 19.8 (3-48) months of follow-up.Conclusions:EL-RLND is a safe and feasible procedure using an improved extraperitoneal approach that provides minimal invasion and rapid recovery of patients. It can be further applicated in clinic, in the case of proficiency in a variety of laparoscopic operations.
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