dc.contributor.author | Gerdtsson, Axel | |
dc.contributor.author | Håkansson, Ulf | |
dc.contributor.author | Törnblom, Magnus | |
dc.contributor.author | Jancke, George | |
dc.contributor.author | Negaard, Helene Francisca Stigter | |
dc.contributor.author | Glimelius, Ingrid | |
dc.contributor.author | Halvorsen, Dag | |
dc.contributor.author | Karlsdottir, Åsa | |
dc.contributor.author | Haugnes, Hege Sagstuen | |
dc.contributor.author | Andreassen, Kristine Engen | |
dc.contributor.author | Larsen, Signe Melsen | |
dc.contributor.author | Holmberg, Göran | |
dc.contributor.author | Wahlqvist, Rolf | |
dc.contributor.author | Tandstad, Torgrim | |
dc.contributor.author | Cohn-Cedermark, Gabriella | |
dc.contributor.author | Ståhl, Olof | |
dc.contributor.author | Kjellmann, Anders | |
dc.date.accessioned | 2021-10-15T07:19:53Z | |
dc.date.available | 2021-10-15T07:19:53Z | |
dc.date.created | 2021-01-08T11:00:06Z | |
dc.date.issued | 2020 | |
dc.identifier.issn | 2588-9311 | |
dc.identifier.uri | https://hdl.handle.net/11250/2823180 | |
dc.description.abstract | Background
Reports on perioperative complications after postchemotherapy retroperitoneal lymph node dissection (PC-RPLND) for nonseminoma germ cell tumour (NSGCT) are from experienced single centres, with a lack of population-based studies.
Objective
To assess the complications of bilateral and unilateral PC-RPLND.
Design, setting, and participants
A prospective, population-based, observational multicentre study included all patients with NSGCT who underwent PC-RPLND in Norway and Sweden during 2007–2014. Of a total of 318 patients, 87 underwent bilateral PC-RPLND and 231 underwent unilateral PC-RPLND. The median follow-up was 6 yr.
Outcome measurements and statistical analysis
Bilateral and unilateral PC-RPLND were compared for the outcomes of intra- and postoperative complications (graded by Clavien-Dindo) and retrograde ejaculation (with or without nerve-sparing surgery). Complications were reported as absolute counts and percentages. The χ2 test was used for comparisons.
Results and limitations
The incidence of intraoperative complications was higher for bilateral PC-RPLND than for unilateral PC-RPLND (14% vs 4.3%, p = 0.003), with ureteral injury as the most frequent reported complication (2% of the patients). Postoperative complications were more common after bilateral than after unilateral PC-RPLND (45% vs 25%, p = 0.001) with Clavien ≥3b reported in 8.3% and 2.2%, respectively (p = 0.009). Lymphatic leakage was the most common complication occurring in 11% of the patients. Retrograde ejaculation occurred more frequently after bilateral than after unilateral surgery (59% vs 32%, p < 0.001). Limitations of the study include reporting of retrograde ejaculation, which was based on a chart review.
Conclusions
Intra- and postoperative complications including retrograde ejaculation are more frequent after bilateral PC-RPLND than after unilateral PC-RPLND.
Patient summary
Lymph node dissection in patients with testicular cancer puts them at risk of complications. In this study, we present the complications after lymph node dissection. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Elsevier | en_US |
dc.title | Surgical Complications in Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminoma Germ Cell Tumour: A Population-based Study from the Swedish Norwegian Testicular Cancer Group | en_US |
dc.type | Journal article | en_US |
dc.description.version | submittedVersion | en_US |
dc.rights.holder | This is the authors' manuscript to an article published by Elsevier | en_US |
dc.source.journal | European Urology Oncology (EUO) | en_US |
dc.identifier.doi | 10.1016/j.euo.2019.08.002 | |
dc.identifier.cristin | 1867594 | |
cristin.ispublished | true | |
cristin.fulltext | preprint | |
cristin.qualitycode | 1 | |