Video endoscopic inguinofemoral lymphadenectomy in penile cancer
https://doi.org/10.17650/726-9776-2022-18-4-72-80
Abstract
Background. Dissection of inguinal lymph nodes is an important method of treatment of invasive and locally advanced penile cancer. Unfortunately, the procedure is associated with very high complication rate exceeding 50 %.
Aim. To perform retrospective comparative analysis of oncological outcomes, intraoperative and early postoperative complications of open and endoscopic inguinofemoral lymphadenectomy in treatment of patients with penile cancer.
Materials and methods. Treatment outcomes of 64 patients with penile cancer who underwent open or video endoscopic lymphadenectomy were analyzed. Primary and secondary surgical treatment outcomes were evaluated.
Results. Open inguinofemoral lymphadenectomy was performed in 54 patients, video endoscopic in 10. Analysis of primary surgical results showed a significant (3-fold) reduction of the duration of lymphorrhea and the duration of hospitalization (2-fold) in patients of the video endoscopic lymphadenectomy group. There was no difference in the number of removed lymph nodes in the two types of surgeries. Average operative time for video endoscopic lymphadenectomy was 15–20 % longer than operative time of open intervention. Analysis of safety indicators showed that during open surgery, the frequency of wound infection was 24 %, skin flap necrosis – 55.5 %, wound dehiscence – 52 %, lymphedema – 15 %. No such complications were observed in lateral video endoscopic inguinofemoral lymphadenectomy.
Conclusion. Video endoscopic inguinofemoral lymphadenectomy has significant advantages compared to open method in terms of reduction of the rate of surgical complications and duration of hospitalization.
About the Authors
E. A. MetelkovaRussian Federation
67 Prospekt Oktyabrya, Yaroslavl 150054
P. V. Nesterov
Russian Federation
67 Prospekt Oktyabrya, Yaroslavl 150054
E. V. Gurin
Russian Federation
67 Prospekt Oktyabrya, Yaroslavl 150054
A. V. Ukharskiy
Russian Federation
Andrey Vyacheslavovich Ukharskiy
67 Prospekt Oktyabrya, Yaroslavl 150054
References
1. Correa A.F., Handorf E., Joshi S.S. et al. Differences in survival by receipt of lymph node dissection in patients with invasive penile cancer: results from the national cancer database. J Urol 2018;199(5):1238–44. DOI: 10.1016/j.juro.2017.11.121
2. Chang S.B., Askew R.L., Xing Y. et al. Prospective assessment of postoperative complications and associated costs following Inguinal Lymph Node Dissection (ILND) in melanoma patients. Ann Surg Oncol 2010;17(10):2764–72. DOI: 10.1245/s10434-010-1026-z
3. Spiess P.E., Hernandez M.S., Pettaway C.A. Contemporary inguinal lymph node dissection: minimizing complications. World J Urol 2009;27(2):205–12. DOI: 10.1007/s00345-008-0324-6
4. Abbott A.M., Grotz T.E., Rueth N.M. et al. Minimally invasive inguinal lymph node dissection (MILND) for melanoma: experience from two academic centers. Ann Surg Oncol 2013;20(1):340–5. DOI: 10.1245/s10434-012-2545-6
5. Bartlett E.K., Meise C., Bansal N. et al. Sartorius transposition during inguinal lymphadenectomy for melanoma. J Surg Res 2013;184(1):209–15. DOI: 10.1016/j.jss.2013.04.033
6. Tauber R., Schmid S., Horn T. et al. Inguinal lymph node dissection: epidermal vacuum therapy for prevention of wound complications. J Plast Reconstr Aesthetic Surg 2013;66(3):390–6. DOI: 10.1016/j.bjps.2012.09.030
7. Sarnaik A.A., Puleo C.A., Zager J.S., Sondak V.K. Limiting the morbidity of inguinal lymphadenectomy for metastatic melanoma. Cancer Control 2009;16(3):240–7. DOI: 10.1177/107327480901600306
8. Tobias-Machado M., Tavares A., Silva M.N.R. et al. Can video endoscopic inguinal lymphadenectomy achieve a lower morbidity than open lymph node dissection in penile cancer patients? J Endourol 2008;22(8):1687–91. DOI: 10.1089/end.2007.0386
9. Jakub J.W., Terando A.M., Sarnaik A. et al. Safety and feasibility of minimally invasive inguinal lymph node dissection in patients with melanoma (SAFE-MILND): report of a prospective multi-institutional trial. Ann Surg 2017;265:192–6. DOI: 10.1097/SLA.0000000000001670
10. Grotz T.E., Huebner M., Pockaj B.A. et al. Limitations of lymph node ratio, evidence-based benchmarks, and the importance of a thorough lymph node dissection in melanoma. Ann Surg Oncol 2013;20(13):4370–7. DOI: 10.1245/s1043 4-013-3186-0
11. Rossi C.R., Mozzillo N., Maurichi A. et al. The number of excised lymph nodes is associated with survival of melanoma patients with lymph nodemetastasis. Ann Oncol 2014;25(1):240–6. DOI: 10.1093/annonc/mdt510
12. Spillane A.J., Haydu L., McMillan W. et al. Quality assurance parameters and predictors of outcome for ilioinguinal and inguinal dissection in a contemporary melanoma patient population. Ann Surg Oncol 2011;18(9):2521–8. DOI: 10.1245/s10434-011-1755-7
13. Martin B.M., Etra J.W., Russell M.C. et al. Oncologic outcomes of patients undergoing videoscopic inguinal lymphadenectomy for metastatic melanoma. J Am Coll Surg 2014;218(4):620–6. DOI: 10.1016/j.jamcollsurg.2013.12.016
14. Li M., Wang S., Guo S., Zhang Z. Endoscopic groin lymphadenectomy with a thigh approach to gynecologic malignancies: a retrospective study with 5-year experience. Int J Gynecol Cancer 2015;25:325–30. DOI: 10.1097/IGC.0000000000000348
15. Master V.A., Jafri S.M.A., Moses K.A. et al. Minimally invasive inguinal lymphadenectomy via endoscopic groin dissection: comprehensive assessment of immediate and long-term complications. J Urol 2012;188(4):1176–80. DOI: 10.1016/j.juro.2012.06.038
16. Pahwa H.S., Misra S., Kumar A. et al. Video Endoscopic Inguinal Lymphadenectomy (VEIL) – a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma. World J Surg Oncol 2013;11:2–7. DOI: 10.1186/1477-7819-11-42
17. Sommariva A., Pasquali S., Cona C. et al. Videoscopic ilioinguinal lymphadenectomy for groin lymph node metastases from melanoma. Br J Surg 2016;103(8):1026–31. DOI: 10.1002/ bjs.10140
18. Nayak S.P., Pokharkar H., Gurawalia J. et al. Efficacy and safety of lateral approach-video endoscopic inguinal lymphadenectomy (L-VEIL) over open inguinal block dissection: a retrospective study. Indian J Surg Oncol 2019;10(3):555–62. DOI: 10.1007/s13193-019-00951-4
19. Kumar V., Sethia K.K. Prospective study comparing videoendoscopic radical inguinal lymph node dissection (VEILND) with open radical ILND (OILND) for penile cancer over an 8-year period. BJU Int 2017;119(4):530–4. DOI: 10.1111/bju.13660
20. Hu J., Li H., Cui Y. et al. Comparison of clinical feasibility and oncological outcomes between video endoscopic and open inguinal lymphadenectomy for penile cancer: a systematic review and metaanalysis. Medicine (Baltimore) 2019;98(22):e15862. DOI: 10.1097/MD.0000000000015862
21. Kroon B.K., Horenblas S., Lont A.P. et al. Patients with penile carcinoma benefit from immediate resection of clinically occult lymph node metastasis. J Urol 2005;173(3):816–9. DOI: 10.1097/01.ju.0000154565.37397.4d
Review
For citations:
Metelkova E.A., Nesterov P.V., Gurin E.V., Ukharskiy A.V. Video endoscopic inguinofemoral lymphadenectomy in penile cancer. Cancer Urology. 2022;18(4):72-80. (In Russ.) https://doi.org/10.17650/726-9776-2022-18-4-72-80