Lymphoscintigraphic Studies of Lymphatic Drainage from the Testes

Yeh, Samuel D. J.; Morse, Michael J.; Grando, Robert; Kleinert, Edward L.; Whitmore, Willet F.

doi:10.1097/00003072-198612000-00004

Cited by 9 publications

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“…The lymphoscintigraphy can readily be applied before and after clinical and surgical treatments and can be used in the follow-up evaluation of patients with lymphedema, lipedema, and other lymphatic diseases. This study could be used to supplement historical and physical examinations and to evaluate the efficacy of drugs, surgical procedures, and physical methods designed to facilitate lymphatic flow [16,24,25].…”

Section: Discussionmentioning

confidence: 99%

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

et al. 2008

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“…The testis and spermatic cord contain lymphatic channels that ascend into the primary nodal sites depending on region (para-caval, inter-aortocaval, and para-aortic nodes). Tumors originating from the right testicle tend to first involve the inter-aortocaval and para-caval nodes whereas those from the left testicle will first spread to the para-aortic lymph nodes [8,9].…”

Section: Surgical Anatomymentioning

confidence: 99%

Nerve-sparing technique in RPLND for testicular cancer

Nalavenkata

Patel

2023

Current Opinion in Urology

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Purpose of reviewThe management of testicular cancer has evolved over time with multimodal therapy. Retroperitoneal lymph node dissection (RPLND), which is a complex and potentially morbid treatment option, remains the mainstay in surgical treatment. This article reviews the surgical template, approach and anatomical considerations with regards to nerve spare in RPLND. Recent findingsThe standard full bilateral RPLND template has evolved over time to include the area between the renal hilum, bifurcation of the common iliac vessels, and the ureters. Morbidity with regards to ejaculatory dysfunction has led to further refinements in this procedure. Advancements in anatomical understanding of the retroperitoneal structures and their relationship to the sympathetic chain and hypogastric plexus has allowed for modification of surgical templates. Further refinements in surgical nerve sparing techniques have improved functional outcomes without sacrificing oncological outcomes. Finally, extraperitoneal access to the retroperitoneum and minimally invasive platforms have been implemented to further reduce morbidity. SummaryRPLND requires strict adherence to oncological surgical principles regardless of template, approach and technique. Contemporary evidence shows that outcomes are best for advanced testis cancer patients when managed at high volume tertiary care facilities with surgical expertise and access to multidisciplinary care.

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“…The knowledge of these patterns by the radiologist is essential for the correct imaging readings. The first site of the lymphatic spread are the retroperitoneal lymph nodes which can be followed by further spread into posterior mediastinum and other distant lymph nodes ( 5 , 13 , 14 ). However, the first site of lymphatic spread in case of a history of undescended testicle, vasectomy or inguinal herniorrhaphy is altered to the ipsilateral pelvic lymph-nodes ( 15 ).…”

Section: The Mode Of Metastatic Spreadmentioning

confidence: 99%

Intricacies of Radiographic Assessment in Testicular Germ Cell Tumors

Makovnik

Rejleková

Uhrin³

et al. 2021

Front. Oncol.

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Testicular germ cell tumors (GCTs) are malignancies with a unique biology, pathology, clinical appearance, and excellent outcomes. A correct radiographic assessment of GCTs is extremely important for the clinical management in several typical scenarios. Advancements in the field of diagnostic medicine bring an increasing number of sophisticated imaging methods to increase the performance of imaging studies. The conventional computed tomography (CT) remains the mainstay of diagnostic imaging in the management of GCTs. While certain improvements in the sensitivity and specificity are suggested with magnetic resonance (MR) imaging with lymphotrophic nanoparticles in evaluating retroperitoneal lymph nodes during the staging procedure, further exploration in larger prospective studies is needed. A common diagnostic dilemma is assessing the post-chemotherapy residual disease in GCTs. Several studies have consistently shown advantages in the utility of positron emission tomography (PET) scanning in post-chemotherapy residual retroperitoneal lymph nodes in patients with seminoma, but not with non-seminoma. Recommendations suggest that seminoma patients with a residual disease in the retroperitoneum larger than 3 cm should be subjected for PET scanning with 18-fluorodeoxyglucose. Relatively high sensitivity, specificity and a negative predictive value (80–95%) may guide clinical decision to spare these patients of high morbidity of an unnecessary surgery. However, a positive predictive value of around 50% renders PET scanning difficult to interpret in the case of positive finding. These patients often require extremely difficult surgical procedures with the high risk of post-operative morbidity. Therefore, seminoma patients with PET positive residual masses larger than 3 cm still remain a serious challenge in the decision making of nuclear medicine specialist, oncologists, and urologic surgeons. In this article, we aim to summarize data on controversial dilemmas in staging procedures, active surveillance, and post-chemotherapy assessment of GCTs based on the available published literature.

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Lymphoscintigraphic Studies of Lymphatic Drainage from the Testes

Cited by 9 publications

References 0 publications

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

Thighplasty After Bariatric Surgery: Evaluation of Lymphatic Drainage in Lower Extremities

Nerve-sparing technique in RPLND for testicular cancer

Intricacies of Radiographic Assessment in Testicular Germ Cell Tumors

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