@Article{,
AUTHOR = {Pranav Sharma, Einar F. Sverrisson, Kamran Zargar-Shoshtari, 
Mayer N. Fishman, Wade J. Sexton, Shohreh I. Dickinson, 
Philippe E. Spiess, Michael A. Poch, Scott M. Gilbert, 
Julio M. Pow-Sang},
TITLE = {Minimally invasive post-chemotherapy retroperitoneal lymph node dissection  for nonseminoma},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {22},
YEAR = {2015},
NUMBER = {4},
PAGES = {7882--7889},
URL = {http://www.techscience.com/CJU/v22n4/61236},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> We present our experience with 
minimally-invasive retroperitoneal lymph node dissection 
(MI-RPLND) in the post-chemotherapy (PC) setting for 
residual masses in patients with nonseminoma.<br/>
<b>Materials and methods:</b> Nineteen men who underwent 
PC MI-RPLND (14 – laparoscopic, 5 – robotic) for 
low-volume residual disease (no more than 5 clinically 
enlarged retroperitoneal masses, size < 5 cm, no adjacent 
organ or vascular invasion) between 2006 and 2011 
were identified. Clinicodemographic information and 
pathological outcomes were reported.<br/>
<b>Results:</b> Median age of our study population was 
32 (interquartile range [IQR]: 28-39). Most patients 
presented with clinical stage II disease (63%) and were 
categorized as good risk (90%) by the International 
Germ Cell Consensus Classification. Median size of 
residual masses on PC imaging was 2.1 cm (IQR: 1.7-3). 
Full-template bilateral RPLND was completed in 53% of 
cases, and modified left-sided RPLND in 47%. Median 
operative time was 370 minutes (IQR: 320-420), and 
median estimated blood loss was 300 cc (IQR: 150-450). 
Median length of stay was 3 days (IQR: 2-3). Five 
patients (26%) experienced a postoperative 30 day 
complication, but none were higher than Clavien grade II. 
On final pathology, median number of lymph nodes 
removed was 12 (IQR: 8-23), and 8 patients (42%) had 
residual teratoma. No patient experienced a recurrence 
at median follow up of 24 months (IQR: 5-76). <br/>
<b>Conclusions:</b> PC MI-RPLND is a feasible option in a 
select group of patients with acceptable patient morbidity 
and short-term outcomes. Longer follow up is required to 
determine the oncologic efficacy of this approach.},
DOI = {}
}