Outcomes of retroperitoneal lymph node dissection for testicular cancer by a high volume surgeon from Australia: a case for centralisation

2021 ◽  
Author(s):  
Isabella S. C. Williams ◽  
John Lahoud ◽  
Howard Gurney ◽  
Malmaruha Arasaratnam ◽  
Manish I. Patel
Keyword(s):  
Lymph Node ◽  
Testicular Cancer ◽  
Lymph Node Dissection ◽  
High Volume ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

scholarly journals Effect of alvimopan on gastrointestinal recovery and length of hospital stay after retroperitoneal lymph node dissection for testicular cancer

2018 ◽  
Vol 12 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Kushan D Radadia ◽  
Nicholas J Farber ◽  
Alexandra L Tabakin ◽  
Wei Wang ◽  
Hiren V Patel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Length Of Stay ◽  
Testicular Cancer ◽  
Lymph Node Dissection ◽  
Length Of Hospital Stay ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

Objective: Alvimopan use has reduced the length of hospital stay in patients undergoing major abdominal surgeries and radical cystectomy. Retroperitoneal lymph node dissection for testicular cancer may be associated with delayed gastrointestinal recovery prolonging hospital length of stay. We evaluate whether alvimopan is associated with enhanced gastrointestinal recovery and shorter hospital length of stay in men undergoing retroperitoneal lymph node dissection for testicular cancer. Materials and methods: From 2010 to 2016, 29 patients underwent open, transperitoneal bilateral template retroperitoneal lymph node dissection. Data for patients who received alvimopan were prospectively collected and compared to a historical cohort of patients who did not receive alvimopan. Primary outcome measures were length of stay and recovery of gastrointestinal function. Descriptive statistics were reported. Time-to-event outcomes were evaluated using cumulative incidence curves and log rank test. Factors associated with length of stay were analyzed for correlation using multiple linear regression. Results: Of 29 men undergoing retroperitoneal lymph node dissection, eight received alvimopan and 21 did not. The two cohorts were well matched, with no significant differences. In the alvimopan cohort compared with those who did not receive alvimopan median time to return of flatus was 2 versus 4 days ( p=0.0002), and median time to first bowel movement was 2.5 versus 5 days ( p=0.046), respectively. Median length of stay in the alvimopan cohort was 4 days versus 6 days in those who did not receive alvimopan ( p=0.074). In adjusted analyses, receipt of alvimopan did not influence length of stay. Conclusion: Alvimopan may facilitate gastrointestinal recovery after retroperitoneal lymph node dissection for testicular cancer. Whether this translates into reduced length of stay needs to be determined by randomized controlled trials using larger cohorts. Level of evidence: 3b.

Sign in / Sign up

Export Citation Format

Share Document