Gao Yilong, Shao Yanxiang, Hu Xu, Meng Linghao, Li Xiang
Department of Urology, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, 610041, China.
Sci Rep. 2025 Mar 20;15(1):9618. doi: 10.1038/s41598-025-94047-5.
Wound related and lymphatic reflow-related complications are commonly seen in penile cancer patients after inguinal lymph node dissection (ILND). However, the risk factors for them remain unclear. The objective of this study is to identify surgical-related risk factors for complications after ILND in penile squamous cell carcinoma (PSCC) patients. In this study, 192 PSCC patients aged 23-88 were enrolled between October 2008 and October 2023. Univariate analysis and logistic regression were performed to identify risk factors. Receiver operating characteristic (ROC) curves were used to analyze the relationship between certain risk factors and postoperative complications and find cut-off points for certain risk factors. Postoperative complications were observed in 87.5% of patients, with lymphatic fistula being the most common (50.0%) and wound dehiscence the least common (1.1%). Different factors were associated with each complication. Additionally, we found that the retention time of the drainage tube correlates with both lymphocele and wound infection, emphasizing the importance of optimizing drainage tube management to reduce lymphatic and wound-related complications. In conclusion, this study identified specific risk factors for complications after ILND in PSCC patients, particularly the shorter and longer retention times of the drainage tube for lymphocele and wound infection as determined by our multivariate analysis, and proposed new strategies to not only reduce the occurrence of these complications but also accelerate the postoperative healing process.
阴茎癌患者腹股沟淋巴结清扫术(ILND)后,伤口相关及淋巴回流相关并发症较为常见。然而,其危险因素仍不明确。本研究旨在确定阴茎鳞状细胞癌(PSCC)患者ILND术后并发症的手术相关危险因素。本研究纳入了2008年10月至2023年10月期间192例年龄在23 - 88岁的PSCC患者。采用单因素分析和逻辑回归确定危险因素。采用受试者工作特征(ROC)曲线分析某些危险因素与术后并发症之间的关系,并找出某些危险因素的截断点。87.5%的患者出现术后并发症,其中淋巴瘘最为常见(50.0%),伤口裂开最不常见(1.1%)。不同因素与每种并发症相关。此外,我们发现引流管留置时间与淋巴囊肿和伤口感染均相关,强调了优化引流管管理以减少淋巴和伤口相关并发症的重要性。总之,本研究确定了PSCC患者ILND术后并发症的特定危险因素,特别是经多因素分析确定的引流管留置时间过短和过长分别与淋巴囊肿和伤口感染相关,并提出了新的策略,不仅可减少这些并发症的发生,还可加速术后愈合过程。