Video endoscopic inguinofemoral lymphadenectomy in penile cancer

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.