Retroperitoneal lymph node dissection (RPLND) templates for right-sided testicular non-seminomatous germ cell tumour (NSGCT) include which primary landing zone?

• A Left para-aortic nodes between the renal veins and inferior mesenteric artery
• B Right iliac nodes, para-aortic nodes, and left interaortocaval nodes equally
• C Pre-aortic nodes only, with skip metastases to supraclavicular nodes
• D Interaortocaval and right paracaval nodes from the renal hilum to the common iliac bifurcation ✓

Explanation

The primary lymphatic landing zone for right testicular tumours is the interaortocaval and right paracaval (right para-aortic) region from the renal hilum to the common iliac bifurcation, reflecting the right testicular lymphatics draining to nodes near the right renal vein. Left testicular tumours drain primarily to left para-aortic nodes. The modified right-template RPLND covers interaortocaval and right paracaval zones to preserve ejaculation by sparing contralateral sympathetic chains.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.