Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes

Background: Open inguinal lymph node dissection (oILND) has high morbidity. Ascending saphenous-sparing video endoscopic ILND (VEILND-AS+) represents a minimally invasive alternative with potential benefits. Objective: To describe our VEILND-AS+ technique and compare outcomes to oILND. Design, setti...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Christian D. Fankhauser, Esther W.C. Lee, Allaudin Issa, Pedro Oliveira, Maurice Lau, Vijay Sangar, Arie Parnham
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Penile cancer Inguinal lymph node dissection Video endoscopic inguinal lymph node dissection Minimally invasive surgery Diseases of the genitourinary system. Urology RC870-923 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/cec54a7a3134479f8622f88d461273bf
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:cec54a7a3134479f8622f88d461273bf
record_format	dspace
spelling	oai:doaj.org-article:cec54a7a3134479f8622f88d461273bf2021-11-20T05:14:02ZSaphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes2666-168310.1016/j.euros.2021.10.004https://doaj.org/article/cec54a7a3134479f8622f88d461273bf2022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666168321027129https://doaj.org/toc/2666-1683Background: Open inguinal lymph node dissection (oILND) has high morbidity. Ascending saphenous-sparing video endoscopic ILND (VEILND-AS+) represents a minimally invasive alternative with potential benefits. Objective: To describe our VEILND-AS+ technique and compare outcomes to oILND. Design, setting, and participants: This was a retrospective cohort study of penile cancer patients. Surgical procedure: VEILND-AS+ was performed according to the technique described in the supplementary video. Measurements: We compared perioperative and pathological outcomes between the two procedures. Results and limitations: In the study cohort of 206 men we performed 40 VEILND-AS+ and 251 oILND procedures. In comparison to oILND, VEILND-AS+ had a longer operation time (185 vs 120 min; p < 0.01) but a shorter hospital stay (2 vs 4 d; p < 0.01). A median of eight resected lymph nodes with a median of one affected node per groin was observed in both groups. Extranodal extension was found in 30% of cases after VEILND-AS+ and 35% after oILND. In both groups the median drainage time was 13 d. Wound infections were observed in 38% of cases after VEILND-AS+ and 27% after oILND (p = 0.19). Skin necrosis or wound breakdown occurred in 0% and 6% of cases after VEILND-AS+ and oILND (p < 0.01), while lymphoceles were drained in 18% and 7% of cases, respectively(p = 0.03). Following VEILND-AS+ and oILND, 20% and 14% of patients, respectively, were referred to a lymph oedema clinic (p < 0.01). Conclusions: VEILND-AS+ is a safe procedure and offers shorter hospital stays and possibly a lower risk of skin necrosis and wound breakdown in comparison to oILND. Further improvements in the VEILND-AS+ technique are required to reduce complications associated with dead space and injury to lymphatic vessels. Patient summary: For patients undergoing surgery on lymph nodes in the groin, a minimally invasive approach instead of open surgery led to discharge 2 days earlier and may have lower rates of severe wound complications.Christian D. FankhauserEsther W.C. LeeAllaudin IssaPedro OliveiraMaurice LauVijay SangarArie ParnhamElsevierarticlePenile cancerInguinal lymph node dissectionVideo endoscopic inguinal lymph node dissectionMinimally invasive surgeryDiseases of the genitourinary system. UrologyRC870-923Neoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENEuropean Urology Open Science, Vol 35, Iss , Pp 9-13 (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Penile cancer Inguinal lymph node dissection Video endoscopic inguinal lymph node dissection Minimally invasive surgery Diseases of the genitourinary system. Urology RC870-923 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	Penile cancer Inguinal lymph node dissection Video endoscopic inguinal lymph node dissection Minimally invasive surgery Diseases of the genitourinary system. Urology RC870-923 Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Christian D. Fankhauser Esther W.C. Lee Allaudin Issa Pedro Oliveira Maurice Lau Vijay Sangar Arie Parnham Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
description	Background: Open inguinal lymph node dissection (oILND) has high morbidity. Ascending saphenous-sparing video endoscopic ILND (VEILND-AS+) represents a minimally invasive alternative with potential benefits. Objective: To describe our VEILND-AS+ technique and compare outcomes to oILND. Design, setting, and participants: This was a retrospective cohort study of penile cancer patients. Surgical procedure: VEILND-AS+ was performed according to the technique described in the supplementary video. Measurements: We compared perioperative and pathological outcomes between the two procedures. Results and limitations: In the study cohort of 206 men we performed 40 VEILND-AS+ and 251 oILND procedures. In comparison to oILND, VEILND-AS+ had a longer operation time (185 vs 120 min; p < 0.01) but a shorter hospital stay (2 vs 4 d; p < 0.01). A median of eight resected lymph nodes with a median of one affected node per groin was observed in both groups. Extranodal extension was found in 30% of cases after VEILND-AS+ and 35% after oILND. In both groups the median drainage time was 13 d. Wound infections were observed in 38% of cases after VEILND-AS+ and 27% after oILND (p = 0.19). Skin necrosis or wound breakdown occurred in 0% and 6% of cases after VEILND-AS+ and oILND (p < 0.01), while lymphoceles were drained in 18% and 7% of cases, respectively(p = 0.03). Following VEILND-AS+ and oILND, 20% and 14% of patients, respectively, were referred to a lymph oedema clinic (p < 0.01). Conclusions: VEILND-AS+ is a safe procedure and offers shorter hospital stays and possibly a lower risk of skin necrosis and wound breakdown in comparison to oILND. Further improvements in the VEILND-AS+ technique are required to reduce complications associated with dead space and injury to lymphatic vessels. Patient summary: For patients undergoing surgery on lymph nodes in the groin, a minimally invasive approach instead of open surgery led to discharge 2 days earlier and may have lower rates of severe wound complications.
format	article
author	Christian D. Fankhauser Esther W.C. Lee Allaudin Issa Pedro Oliveira Maurice Lau Vijay Sangar Arie Parnham
author_facet	Christian D. Fankhauser Esther W.C. Lee Allaudin Issa Pedro Oliveira Maurice Lau Vijay Sangar Arie Parnham
author_sort	Christian D. Fankhauser
title	Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
title_short	Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
title_full	Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
title_fullStr	Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
title_full_unstemmed	Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes
title_sort	saphenous-sparing ascending video endoscopic inguinal lymph node dissection using a leg approach: surgical technique and perioperative and pathological outcomes
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/cec54a7a3134479f8622f88d461273bf
work_keys_str_mv	AT christiandfankhauser saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT estherwclee saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT allaudinissa saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT pedrooliveira saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT mauricelau saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT vijaysangar saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes AT arieparnham saphenoussparingascendingvideoendoscopicinguinallymphnodedissectionusingalegapproachsurgicaltechniqueandperioperativeandpathologicaloutcomes
_version_	1718419510957965312

Saphenous-sparing Ascending Video Endoscopic Inguinal Lymph Node Dissection Using a Leg Approach: Surgical Technique and Perioperative and Pathological Outcomes

Ejemplares similares