Retroperitoneoscopy for the diagnosis of infiltrating retroperitoneal lymphadenopathy and masses

Background Retroperitoneoscopy (RPS) is a form of direct vision endoscopy, used to explore the retroperitoneal space, and was first described by Bartel in 1969. Methods RPS was performed prospectively to diagnose infiltrating retroperitoneal lymphadenopathy or masses when needle aspiration biopsy under computed tomographic guidance (NABCT) failed to establish a definite diagnosis. Results From May 1985 to August 1995, RPS was performed in 118 patients (121 procedures). Mean hospital stay was 2·4 (range 2–5) days. The peroperative and perioperative morbidity rate was 6·6 per cent of the procedures. A precise diagnosis was obtained in 108 of the 118 patients. The sensitivity was 84 per cent for malignant lymphoma, 94 per cent for Hodgkin's lymphoma, 95 per cent for metastatic lymph nodes of carcinomas and 100 per cent for primary retroperitoneal tumours. The overall sensitivity was 91·5 per cent. Conclusion RPS is an alternative procedure to NABCT when aspiration biopsy is not technically feasible because a lesion is too small to sample or failed to establish a precise histopathological diagnosis.