Kandasamy Shreedhar Gurunathan, Chandran Kosur Ravi, Pooleri Ginil Kumar
Department of Urology, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Indian J Urol. 2022 Jan-Mar;38(1):15-21. doi: 10.4103/iju.iju_387_21. Epub 2022 Jan 1.
Inguinal lymph node dissection (ILND) is an integral part in the management of carcinoma penis. The concerns about the postoperative morbidity associated with open ILND led to modification in the template of dissection and adoption of minimally invasive techniques such as video endoscopic inguinal lymphadenectomy (VEIL) and robotic-assisted VEIL (R-VEIL). In this review, we aim to describe the techniques, case selection, perioperative outcomes, and oncological outcomes of VEIL and R-VEIL and to compare it with open ILND.
Databases of PubMed, Embase, and Google Scholar were searched to identify the articles for VEIL and R-VEIL. Using PRISMA guidelines, literature search yielded 3783 articles, of which 32 full-text articles relevant to the topic were selected and reviewed, after consensus from authors.
After the first description of VEIL, various modifications in port placements and approaches were described. Several studies have shown, VEIL and R VEIL are safe and feasible in both node-negative and node-positive Ca penis patients. Compared to open ILND, VEIL had fewer wound infections and skin necrosis, minimal blood loss, shorter mean hospital stays, and reduced duration of drain kept. There is no difference in mean lymph node yield and recurrence rates between open ILND, VEIL, R-VEIL.
VEIL and R-VEIL are safe and have comparable oncological outcomes with open ILND.
腹股沟淋巴结清扫术（ILND）是阴茎癌治疗的一个重要组成部分。对开放性ILND术后发病率的担忧促使人们对清扫模板进行了改进，并采用了微创技术，如视频内镜腹股沟淋巴结切除术（VEIL）和机器人辅助VEIL（R-VEIL）。在本综述中，我们旨在描述VEIL和R-VEIL的技术、病例选择、围手术期结果和肿瘤学结果，并将其与开放性ILND进行比较。
检索PubMed、Embase和谷歌学术数据库，以确定有关VEIL和R-VEIL的文章。根据PRISMA指南，文献检索共获得3783篇文章，经作者协商一致后，从中筛选出32篇与该主题相关的全文文章进行综述。
在首次描述VEIL之后，人们又描述了端口放置和手术入路的各种改进。多项研究表明，VEIL和R-VEIL在阴茎癌淋巴结阴性和阳性患者中都是安全可行的。与开放性ILND相比，VEIL的伤口感染和皮肤坏死较少，出血量极少，平均住院时间较短，引流时间缩短。开放性ILND、VEIL、R-VEIL之间的平均淋巴结收获量和复发率没有差异。
VEIL和R-VEIL是安全的，其肿瘤学结果与开放性ILND相当。
