754 ENDOSCOPIC INGUINOFEMORAL LYMPHADENECTOMY FOR PENILE MALIGNANCIES – EXTENDED FOLLOW-UP
2012-04-01

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease II1 Apr 2012754 ENDOSCOPIC INGUINOFEMORAL LYMPHADENECTOMY FOR PENILE MALIGNANCIES – EXTENDED FOLLOW-UP Christian Schwentner, Joerg Seibold, Stefan Aufderklamm, Saladin Alloussi, Tilman Todenhöfer, David Schilling, Arnulf Stenzl, and Georgios Gakis Christian SchwentnerChristian Schwentner Tuebingen, Germany More articles by this author , Joerg SeiboldJoerg Seibold Tuebingen, Germany More articles by this author , Stefan AufderklammStefan Aufderklamm Tuebingen, Germany More articles by this author , Saladin AlloussiSaladin Alloussi Tuebingen, Germany More articles by this author , Tilman TodenhöferTilman Todenhöfer Tuebingen, Germany More articles by this author , David SchillingDavid Schilling Tuebingen, Germany More articles by this author , Arnulf StenzlArnulf Stenzl Tuebingen, Germany More articles by this author , and Georgios GakisGeorgios Gakis Tuebingen, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.840AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Inguinofemoral lymphadenectomy is a standard procedure for genitourinary malignancies. Open lymphadenectomy is associated with complication rates exceeding 50%. We present our long-term experience with modified endoscopic inguinofemoral lymphadenectomy (EL). METHODS Patients with palpable and non non-palpable nodes who underwent inguinofemoral lymphadenectomy were identified. OL consisted of classical superficial and deep inguinofemoral lymph node dissection. EL was done using a 3-trocar approach respecting the same boundaries. We apply a reduced CO2-pressure of 5 mmHg. A suction drain was always placed. Operative data and postoperative outcomes were assessed and statistically compared. RESULTS We performed 60 inguinofemoral lymph node dissections in 41 patients. 26 procedures were completed endoscopically. Follow-up was 55.3 months (2-87). Mean OR-time for OL was 101.7 minutes (38-195) being significantly shorter than for EL (136.3 minutes, 87-186), p<0.001. Both groups are comparable with respect to the number of nodes (OL 7.2, 2-16 vs EL 6.9, 4-13) as well as to the number of affected nodes (OL 1.8 vs EL 1.6). Leg edema or secondary wound healing occurred extremely rare (1/26) after EL leaving an overall complication rate of 7.7 %. Complications appeared in more than half of the OL-cases (55.3%). There were no problems due to CO2-insufflation. Rates of local recurrence and systemic spread were identical in OL vs EL. CONCLUSIONS OL and EL are reliable for inguinofemoral lymphadenectomy regarding oncological efficacy. EL may be more technically challenging. EL can avoid secondary wound healing and lymphatic stasis. EL is safe with a low complication rate. A reduction of CO2-pressures attributes to the safety profile. Since cancer control rates remained equivalent during an extended follow-up oncological durability could be confirmed. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e308 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Schwentner Tuebingen, Germany More articles by this author Joerg Seibold Tuebingen, Germany More articles by this author Stefan Aufderklamm Tuebingen, Germany More articles by this author Saladin Alloussi Tuebingen, Germany More articles by this author Tilman Todenhöfer Tuebingen, Germany More articles by this author David Schilling Tuebingen, Germany More articles by this author Arnulf Stenzl Tuebingen, Germany More articles by this author Georgios Gakis Tuebingen, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...