Department of Surgery, Chashan Hospital of Guangdong Medical University, 92 Caihong Road, Chashan Town, Dongguan, 523127, Guangdong, People's Republic of China.
Surg Endosc. 2024 Jan;38(1):179-185. doi: 10.1007/s00464-023-10542-8. Epub 2023 Nov 10.
Penile carcinoma is an uncommon cancer that develops in the penis tissue. The standard surgical method to manage regional lymph nodes after local excision is radical inguinal lymphadenectomy, but it has a high rate of complications. The objective of this retrospective study was to compare the long-term outcomes of endoscopic inguinal lymphadenectomy and open inguinal lymphadenectomy in patients with penile carcinoma.
The study included patients diagnosed with penile carcinoma who underwent open inguinal lymphadenectomy (n = 23) or endoscopic inguinal lymphadenectomy (n = 27) at a single hospital between January 2013 and January 2021. Operation time, blood loss, drainage, hospital stay, postoperative complications, and survival rates were assessed and compared between the two groups.
The two groups were comparable in terms of age, tumor size and stage, inguinal lymph nodes, and follow-up. The endoscopic group had significantly lower blood loss (27.1 ± 1.5 ml vs 55.0 ± 2.7 ml, P < 0.05), shorter drainage time and hospital stay (4.7 ± 1.1 days vs 8.1 ± 2.2 days, and 13.4 ± 1.0 days vs 19 ± 2.0 days, respectively, P < 0.05), and longer operation time compared to the open group (82.2 ± 4.3 min in endoscopic group vs 53.1 ± 2.2 min in open group, P < 0.05). There were significant differences in the incidence of incisional infection, necrosis, and lymphorrhagia in both groups (4 vs 0, 4 vs 0, and 2 vs 0, respectively, P < 0.05). The inguinal lymph node harvested was comparable between the two groups. The mean follow-up time was similar for both groups (60.4 ± 7.7 m vs 59.8 ± 7.3 m), and the recurrence mortality rates were not significantly different.
The study shows that both open and endoscopic methods work well for controlling penile carcinoma in the long term. But the endoscopic approach is better because it has fewer severe complications. So, the choice of surgery method might depend on factors like the surgeon's experience, what they like, and what resources are available.
阴茎癌是一种罕见的癌症，发生在阴茎组织中。局部切除后管理区域淋巴结的标准手术方法是根治性腹股沟淋巴结清扫术，但它有很高的并发症发生率。本回顾性研究的目的是比较内镜腹股沟淋巴结清扫术和开放性腹股沟淋巴结清扫术在阴茎癌患者中的长期疗效。
本研究纳入 2013 年 1 月至 2021 年 1 月在一家医院接受开放性腹股沟淋巴结清扫术（n=23）或内镜腹股沟淋巴结清扫术（n=27）治疗的阴茎癌患者。评估并比较两组患者的手术时间、出血量、引流、住院时间、术后并发症和生存率。
两组患者的年龄、肿瘤大小和分期、腹股沟淋巴结和随访情况相似。内镜组的出血量明显低于开放组（27.1±1.5 ml 比 55.0±2.7 ml，P<0.05），引流时间和住院时间更短（4.7±1.1 天比 8.1±2.2 天，13.4±1.0 天比 19±2.0 天，P<0.05），手术时间也长于开放组（内镜组 82.2±4.3 min 比开放组 53.1±2.2 min，P<0.05）。两组切口感染、坏死和淋巴漏的发生率均有显著差异（4 例比 0 例，4 例比 0 例，2 例比 0 例，P<0.05）。两组腹股沟淋巴结清扫数量无差异。两组平均随访时间相似（60.4±7.7 m 比 59.8±7.3 m），复发死亡率无显著差异。
本研究表明，开放性和内镜性方法均可长期有效控制阴茎癌。但内镜方法更好，因为它有更少的严重并发症。因此，手术方法的选择可能取决于外科医生的经验、个人喜好和可用资源等因素。
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