A new method of radical orchiectomy for testicular cancer

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Resumo

This article presents our experience of performing a new laparoscopic method of radical orchiectomy.

At the JSC «European Medical Center» in the period from 2022 to 2024 we performed laparoscopic radical orchiectomies in three patients with testicular cancer. All patients were examined on an outpatient basis, ultrasound and MRI of the scrotum, PET-CT scan were performed, and laboratory tests were carried out. Malignant testicular lesion was confirmed in all patients.

All operations were performed in full volume, without complications during the operation and in the postoperative period. The duration of the laparoscopic surgery was comparable to the standard open technique. In the postoperative period the pain intensity in the area of surgery, the recovery period and the presence of complications were evaluated.

Conclusion: Radical orchiectomy with laparoscopic assistance is a minimally invasive method of surgical treatment of testicular tumors, which allows to perform the removal of the testis and elements of the spermatic cord as radically and safely as possible, and also has pronounced advantages in the form of reduction of postoperative pain syndrome in the area of surgery (no more than 2 points on VAS), reduction of the recovery period and the risk of possible postoperative complications.

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Sobre autores

A. Kovalenko

European Medical Center

Autor responsável pela correspondência
Email: akovalenko@emcmos.ru

urologist 

Rússia, Moscow

N. Grigoriev

European Medical Center

Email: grigna69@gmail.com

Ph.D., MD, professor, Chief of the Urologic Clinic of the «European Medical Center», Head of the Department of Urology of «EMC Medical School»

Rússia, Moscow

L. Tikhonova

European Medical Center

Email: ltihonova@emcmos.ru

Ph.D., urologist 

Rússia, Moscow

Bibliografia

  1. Chissov V.I., Daryalova S.L. Clinical recommendations. Oncology. M.: GEOTAR-Media, 2006. Russian (Чиссов В.И., Дарьялова С.Л. Клинические рекомендации. Онкология. М.: ГЭОТАР-Медиа, 2006).
  2. Laguna M.P., Klepp O., Horwich A. et al. Guidelines on testicular cancer. Update March, 2004.
  3. Huyghe E., Plante P., Thonneau P.F. Testicular cancer variations in time and space in Europe. Eur Urol. 2007;51(3):621–28. doi: 10.1016/j.eururo.2006.08.024.
  4. Huyghe E., Matsuda T., Thonneau P. Increasing incidence of testicular cancer worldwide: a review. J Urol. 2003;170(1):5–11. doi: 10.1097/01.ju.0000053866.68623.da.
  5. Bosl G.J., Motzer R.J. Testicular germ-cell cancer. N. Engl. J. Med. 1997;337:242–253.
  6. Dieckmann K.P., Loy V., Buttner P. Prevalence of bilateral germ cell tumors and early detection based on contralateral testicular intra-epithelial neoplasia. Br. J. Urol. 1993;71:340–345.

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2. Fig. 1. Scheme of trocar placement for performing the laparoscopic stage of the proposed orchiectomy method

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3. Fig. 2. Intraoperative picture of the internal inguinal ring with elements of the spermatic cord.

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4. Fig. 3. Intraoperative picture of the mobilized spermatic cord in the inguinal canal.

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5. Fig. 4. Intraoperative picture of the inguinal canal without the spermatic cord.

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6. Fig. 5. Intraoperative picture of suturing of the internal inguinal ring.

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7. Fig. 6. Macroscopic specimen of the removed testicle with the spermatic cord

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