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腹膜后淋巴结切除(RPLND)治疗睾丸非精原细胞瘤有两个好处:其一,该肿瘤首先向腹膜后淋巴结转移。对大多数ⅡA期肿瘤,RPLND可达到根治目的。其二,可达到精确的临床分期目的。然而,转统的RPLND术,破坏了支配射精管及精囊的交感神经,其主要缺点是术后射精功能障碍。为此,作者设计了一种改良的RPLNO术式,腹膜后淋巴结切除范围自肠系膜下动脉以上至肾动脉、静脉水平。从1976年至1985年,行传统的RPLND术21例(A组),改良RPLND术19例(B组)。术后随
Resection of the retroperitoneal lymph node (RPLND) has two benefits in the treatment of testicular non-seminoma: First, the tumor first metastasizes to the retroperitoneal lymph node. For most stage IIA tumors, RPLND can achieve the purpose of radical cure. Second, accurate clinical stages can be achieved. However, the conventional RPLND surgery destroys the sympathetic nerves that govern the ejaculatory duct and the seminal vesicles. Its main drawback is postoperative ejaculation dysfunction. To this end, the authors designed a modified RPLNO procedure with retroperitoneal lymph node resection from superior mesenteric artery to renal artery and vein. From 1976 to 1985, 21 patients underwent conventional RPLND (group A) and 19 patients underwent modified RPLND (group B). After surgery