Chylous Ascites

TUESDAY, Nov. 5, 2024 -- Open primary retroperitoneal lymph node dissection (RPLND) has an acceptable morbidity profile in men with testicular cancer , according to a study published online Sept. 3 in BJU International . Jacob D. McFadden, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues characterized current perioperative outcomes and short-term complication rates for open primary retroperitoneal lymph node dissection. The analysis included 165 patients undergoing surgery from 2018 to 2021. The researchers found that patients most often had clinical stage IIA (39 percent) or IIB testicular cancer (36 percent). No transfusions were required, and median estimated blood loss was 150 mL. Compared with normal recovery, higher body mass index (median, 28.6 kg/m 2 ) was seen in patients who sustained any complication. Three days was the median length of hospital stay. There was a low overall complication rate (8.48 percent), with two major postoperative complications, including one case of chylous ascites (0.6 percent). No deaths were seen in the 30-day period. "While contemporary reports on the robotic approach to primary RPLND indicate feasibility and potential benefits with respect to blood loss and hospital stay, our report suggests that the open approach remains the ‘gold standard’ by most peri-operative metrics," the authors write.