Patel Keval N, Salunke Abhijeet, Bakshi Ganesh, Jayaprakash Dipin, Pandya Shashank J
Department of Surgical Oncology, The Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.
Department of Surgical Oncology, The Gujarat Cancer Research Institute, Ahmedabad, Gujarat, India.
Urol Oncol. 2022 Mar;40(3):112.e11-112.e22. doi: 10.1016/j.urolonc.2021.11.010. Epub 2021 Dec 9.
To perform a systematic review and meta-analysis evaluating the peri-operative outcomes, complications, and oncological outcomes of Robotic-Assisted Video-Endoscopic Inguinal Lymphadenectomy (RAVEIL)/Video-Endoscopic Inguinal Lymphadenectomy (VEIL) with Open Inguinal Lymph-Node Dissection (OILND) for management of inguinal lymph-nodes in carcinoma of the penis.
A comprehensive literature search was performed in January 2021 using the PubMed, Embase, and Cochrane databases. Data from human studies comparing RAVEIL/VEIL vs. OILND in carcinoma of penis published in English was extracted and analyzed by two independent authors.
Two Randomised Controlled Trials and 6 cohort studies were included in the meta-analysis. RAVEIL/VEIL group exhibited increased operative time (Mean Difference [MD] = 15.28 [14.19; 16.38], P < 0.001), shorter hospital stay (MD = -1.06 [-1.14; -0.98], P < 0.001), and decreased duration of drainage (MD = -2.82 [-3.21; -2.43], P < 0.001), wound infection (Odds Ratio [OR] = 0.15 [0.08; 0.27], P < 0.001), skin necrosis (OR = 0.12 [0.05; 0.28], P < 0.001), lymphedema (OR = 0.41 [0.24; 0.72], P = 0.002), and major complications (OR = 0.11 [0.05; 0.24], P < 0.001) as compared to OILND group. Recurrence rate and number of deaths were comparable in both the groups. RAVEIL/VEIL groups showed slightly larger lymph-node yield (MD = 0.44 [0.18; 0.70], P < 0.001) as compared to OILND group.
RAVEIL/VEIL has lesser skin complications, lymphedema, and better lymph-node yield as compared to OILND. It is comparable in terms of lymphocele and recurrence. It has lesser hospital stay and duration of drainage but owing to heterogeneity, the results should be interpreted with caution. Further studies are required to determine long-term oncological outcomes like overall survival and disease-specific survival.
进行一项系统评价和荟萃分析，评估机器人辅助视频内镜腹股沟淋巴结清扫术（RAVEIL）/视频内镜腹股沟淋巴结清扫术（VEIL）与开放腹股沟淋巴结清扫术（OILND）治疗阴茎癌腹股沟淋巴结的围手术期结局、并发症及肿瘤学结局。
2021年1月利用PubMed、Embase和Cochrane数据库进行全面的文献检索。两名独立作者提取并分析了英文发表的比较RAVEIL/VEIL与OILND治疗阴茎癌的人体研究数据。
荟萃分析纳入了两项随机对照试验和6项队列研究。与OILND组相比，RAVEIL/VEIL组手术时间延长（平均差[MD]=15.28[14.19；16.38]，P<0.001），住院时间缩短（MD=-1.06[-1.14；-0.98]，P<0.001），引流时间缩短（MD=-2.82[-3.21；-2.43]，P<0.001），伤口感染（比值比[OR]=0.15[0.08；0.27]，P<0.001）、皮肤坏死（OR=0.12[0.05；0.28]，P<0.001）、淋巴水肿（OR=0.41[0.24；0.72]，P=0.002）及主要并发症（OR=0.11[0.05；0.24]，P<0.001）发生率降低。两组的复发率和死亡人数相当。与OILND组相比，RAVEIL/VEIL组的淋巴结获取量略多（MD=0.44[
