Romanelli P, Nishimoto R, Suarez R, Decia R, Abreu D, Machado M, Arroyo C, Campolo H, Campos E, Carlos A S, Tobias-Machado M
Servicio de Urología, Hospital Alberto Cavalcanti, Belo Horizonte, Brasil.
Actas Urol Esp. 2013 May;37(5):305-10. doi: 10.1016/j.acuro.2012.11.012. Epub 2013 Feb 20.
We evaluated the reproducibility of video endoscopic inguinal lymphadenectomy (VEIL) and we report our initial experience in the treatment of penile cancer with palpable inguinal lymph nodes.
From July 2006 to November 2010 were conducted 33 VEIL in 20 patients as complementary treatment for penile cancer in two referral hospitals in Latin America. We analyzed the epidemiological and clinical characteristics of patients and surgical and oncologic outcomes.
Fifty-five percent of the patients included were clinical stage N0 and 45% were N +. Thirteen patients underwent bilateral VEIL and the remaining seven underwent VEIL unilateral and conventional open surgery in the contralateral limb. The average operative time for VEIL was 119 minutes and mean resected lymph nodes was 8 per lymphadenectomy. The overall complication rate was 33.2%. No patient had skin necrosis. The lymphatic complication rate was 27.2%. Of the 6 cases in which the saphenous vein was preserved (18.2%) there were no lymphatic complications (P=,2). The overall survival rate was 80% and cancer-specific survival was 90%. Mean follow-up was 20 months.
VEIL in the adjunctive treatment of penile cancer is safe, reproducible and may be an alternative to conventional lymphadenectomy. Patients with palpable lymphadenopathy also may benefit from this technique. Oncological results seem to be adequate however require longer follow-up to be confirmed.
我们评估了视频内镜下腹股沟淋巴结清扫术(VEIL)的可重复性,并报告了我们在治疗伴有可触及腹股沟淋巴结的阴茎癌方面的初步经验。
2006年7月至2010年11月期间,在拉丁美洲的两家转诊医院对20例患者进行了33例VEIL,作为阴茎癌的辅助治疗。我们分析了患者的流行病学和临床特征以及手术和肿瘤学结果。
纳入患者中55%为临床N0期,45%为N +期。13例患者接受了双侧VEIL,其余7例接受了单侧VEIL,并在对侧肢体进行了传统开放手术。VEIL的平均手术时间为119分钟,每次淋巴结清扫平均切除淋巴结8个。总体并发症发生率为33.2%。无患者发生皮肤坏死。淋巴并发症发生率为27.2%。在保留大隐静脉的6例患者中(18.2%),无淋巴并发症发生(P = 0.2)。总体生存率为80%,癌症特异性生存率为90%。平均随访时间为20个月。
VEIL作为阴茎癌的辅助治疗是安全、可重复的,可能是传统淋巴结清扫术的一种替代方法。有可触及淋巴结病患者也可能从该技术中获益。肿瘤学结果似乎是合适的,但需要更长时间的随访来证实。