Simultaneous Bilateral Video-Endoscopic Inguinal Lymphadenectomy for Penile Carcinoma: Surgical Setting, Feasibility, Safety, and Preliminary Oncological Outcomes
Por:
Gaya, JM, Basile, G, Gavrilov, P, Gallioli, A, Territo, A, Robalino, J, Hernandez, P, Sanchez-Molina, R, Bravo, A, Algaba, F, Huguet, J, Sanguedolce, F, Palou, J, Rosales, A, Breda, A
Publicada:
1 dic 2023
Resumen:
Introduction: Inguinal lymph node dissection (ILND) plays an important role for both staging and treatment purposes in patients diagnosed with penile carcinoma (PeCa). Video-endoscopic inguinal lymphadenectomy (VEIL) has been introduced to reduce complications, and in those patients elected for bilateral ILND, a simultaneous bilateral VEIL (sB-VEIL) has also been proposed. This study aimed to investigate the feasibility, safety, and preliminary oncological outcomes of sB-VEIL compared to consecutive bilateral VEIL (cB-VEIL). Material and methods: Clinical N0-2 patients diagnosed with PeCa and treated with cB-VEIL and sB-VEIL between 2015 and 2023 at our institution were included. Modified ILND was performed in cN0 patients, while cN+ patients underwent a radical approach. Intra- and postoperative complications, operative time, time of drainage maintenance, length of hospital stay and readmission within 90 days, as well as lymph node yield, were compared between the two groups. Results: Overall, 30 patients were submitted to B-VEIL. Of these, 20 and 10 patients underwent cB-VEIL and sB-VEIL, respectively. Overall, 16 (80%) and 7 (70%) patients were submitted to radical ILND due to cN1-2 disease in the cB-VEIL and sB-VEIL groups, respectively. No statistically significant difference emerged in terms of median nodal yield (13.5 vs. 14, p = 0.7) and median positive LNs (p = 0.9). sD-VEIL was associated with a shorter operative time (170 vs. 240 min, p < 0.01). No statistically significant difference emerged in terms of intraoperative estimated blood loss, length of hospital stay, time to drainage tube removal, major complications, and hospital readmission in the cB-VEIL and sB-VEIL groups, respectively (all p > 0.05). Conclusions: Simultaneous bilateral VEIL is a feasible and safe technique in patients with PeCA, showing similar oncological results and shorter operative time compared to a consecutive bilateral approach. Patients with higher preoperative comorbidity burden or anesthesiological risk are those who may benefit the most from this technique.
Filiaciones:
Gaya, JM:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Basile, G:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Univ Vita Salute San Raffaele, Dept Urol, I-08025 Milan, Italy
Gavrilov, P:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Gallioli, A:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Territo, A:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Robalino, J:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Hernandez, P:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Sanchez-Molina, R:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Bravo, A:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Algaba, F:
Autonomous Univ Barcelona, Dept Pathol, Fundacio Puigvert, Barcelona 08025, Spain
Huguet, J:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Sanguedolce, F:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Sassari Univ, Dept Med Surg & Pharm, I-07100 Sassari, Italy
Palou, J:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Rosales, A:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
Breda, A:
Autonomous Univ Barcelona, Dept Urol, Fundacio Puigvert, Barcelona 08025, Spain
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