Nabavizadeh Reza, Petrinec Benjamin, Necchi Andrea, Tsaur Igor, Albersen Maarten, Master Viraj
Department of Urology, Emory University School of Medicine, Atlanta, GA 30322, USA.
Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy.
J Clin Med. 2020 Aug 3;9(8):2501. doi: 10.3390/jcm9082501.
Our aim is to review the benefits as well as techniques, surgical outcomes, and complications of minimally invasive inguinal lymph node dissection (ILND) for penile cancer. The PubMed, Wiley Online Library, and Science Direct databases were reviewed in March 2020 for relevant studies limited to those published in English and within 2000-2020. Thirty-one articles describing minimally invasive ILND were identified for review. ILND has an important role in both staging and treatment of penile cancer. Minimally invasive technologies have been utilized to perform ILND in penile cancer patients with non-palpable inguinal lymph nodes and intermediate to high-risk primary tumors or patients with unilateral palpable non-fixed inguinal lymph nodes measuring less than 4 cm, including videoscopic endoscopic inguinal lymphadenectomy (VEIL) and robotic videoscopic endoscopic inguinal lymphadenectomy (RVEIL). Current data suggest that VEIL and RVEIL are feasible and safe with minimal intra-operative complications. Perhaps the strongest appeal for the use of minimally-invasive approaches is their faster post-operative recovery and less post-operative complications. As a result, patients can tolerate this procedure better and surgeons can offer surgery to patients who otherwise would not be a candidate or personally willing to undergo surgery. When compared to open technique, VEIL and RVEIL have similar dissected nodal count, a surrogate metric for oncological adequacy, and a none-inferior inguinal recurrence rate. Larger randomized studies are encouraged to investigate long-term outcome and survival rates using these minimally-invasive techniques for ILND.
我们的目的是回顾微创腹股沟淋巴结清扫术（ILND）治疗阴茎癌的益处、技术、手术结果及并发症。2020年3月检索了PubMed、Wiley Online Library和Science Direct数据库，纳入2000年至2020年期间发表的英文相关研究。共筛选出31篇描述微创ILND的文章进行综述。ILND在阴茎癌的分期和治疗中均具有重要作用。微创技术已被用于对腹股沟淋巴结不可触及且原发肿瘤为中高危或单侧可触及、不固定且直径小于4 cm腹股沟淋巴结的阴茎癌患者进行ILND，包括视频内镜腹股沟淋巴结清扫术（VEIL）和机器人视频内镜腹股沟淋巴结清扫术（RVEIL）。目前的数据表明，VEIL和RVEIL可行且安全，术中并发症极少。使用微创方法的最大吸引力可能在于其术后恢复更快、术后并发症更少。因此，患者对该手术的耐受性更好，外科医生也能够为那些原本不符合条件或不愿意接受手术的患者提供手术。与开放手术相比，VEIL和RVEIL的清扫淋巴结数量相似，这是衡量肿瘤学充分性的替代指标，且腹股沟复发率不劣于开放手术。鼓励开展更大规模的随机研究，以调查使用这些微创技术进行ILND的长期结果和生存率。
