924 UTILIZATION AND COMPLICATIONS OF RETROPERITONEAL LYMPH NODE DISSECTION FROM THE NATIONWIDE INPATIENT SAMPLE

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease III1 Apr 2012924 UTILIZATION AND COMPLICATIONS OF RETROPERITONEAL LYMPH NODE DISSECTION FROM THE NATIONWIDE INPATIENT SAMPLE Diana K. Bowen, Lee C. Zhao, John P. Cashy, and Shilajit D. Kundu Diana K. BowenDiana K. Bowen Chicago, IL More articles by this author , Lee C. ZhaoLee C. Zhao Chicago, IL More articles by this author , John P. CashyJohn P. Cashy Chicago, IL More articles by this author , and Shilajit D. KunduShilajit D. Kundu Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1021AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Retroperitoneal lymph node dissection (RPLND) is an integral component of the management of testis cancer. We attempted to determine the utilization of open versus laparoscopic technique as well as the occurrence of common complications post-operatively. METHODS Using the Nationwide Inpatient Sample Database (NIS), we identified 622 patients from the years 2002 to 2008 with ICD-9 codes for both testis cancer and excision of lymph nodes (189 and 40.3, 40.50-40.59 respectively) as representative of those undergoing RPLND. The mean age ± SD was 29.8 ± 10 years (range of 2 to 71). RESULTS Length of hospital stay after RPLND was 5.5 ± 3.6 days, with a range of 1-38 days. The vast majority of procedures (83%) were performed at urban teaching hospitals. Insertion of ureteral stent was performed in 4% of cases. Pulmonary embolism (PE) was reported at 2.4% (15 of 622), with no reported incidence of deep venous thrombosis (DVT). There were no reported mortalities. RPLND was performed laparoscopically in 1.93% of the total number of procedures (12 of 622). Complications that occurred too infrequently to report in the NIS included chylous leak, ileus or bowel obstruction as represented by TPN coding, vena cava resection, bowel injury, and post-operative respiratory distress. CONCLUSIONS Complications of DVT and PE were relatively rare in this group of younger patients and with no associated mortality, an important observation as prophylactic anticoagulation may be associated with lymphatic leakage. Although these procedures were performed most frequently at urban teaching hospitals, RPLND was performed laparoscopically less than 2% of the time, perhaps reflecting persistent concerns over quality of dissection and oncologic control. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e376 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Diana K. Bowen Chicago, IL More articles by this author Lee C. Zhao Chicago, IL More articles by this author John P. Cashy Chicago, IL More articles by this author Shilajit D. Kundu Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...