Alqudrah Fayssal, Passarelli Rachel, Sykes Jennifer, Islam Raeesa, Chua Kevin, Ghodoussipour Saum
Division of Urology, Robert Wood Johnson Medical School, New Brunswick, NJ 08901, USA.
Section of Urologic Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA.
J Mens Health. 2024 Jul;20(7):20-25. doi: 10.22514/jomh.2024.106. Epub 2024 Jul 30.
Penile cancer accounts for about 1% of all male cancer diagnoses in the United States. Regional lymph node involvement is strongly correlated with overall outcomes, and as such the procedure of inguinal lymph node dissection (ILND) is imperative to the diagnostic and oncologic outcomes for these patients. The current gold standard of open ILND presents challenges in mitigating detrimental postoperative sequalae such as wound complications and lymphedema, without compromising oncologic outcomes. There has been a growing interest and shift in minimally invasive (MIS) approaches to tackle the challenges seen in the open approach to ILND. Several different minimally invasive techniques such as laparoscopic video-endoscopic inguinal lymphadenectomy (VEIL) and robotic-assisted VEIL approaches have been explored and described in the literature. A systematic literature search of PubMed and Medline (OVID) literature review was performed to assess outcomes in MIS approaches to ILND in comparison to traditional open approach. Key words included penile cancer/penile neoplasms, minimally-invasive procedures, robotics, video-endoscopic, robotic-assisted, inguinal lymphadenectomy, and inguinal lymph node dissections. Studies show that MIS approaches to ILND have potential to reduce high-grade postoperative complications, operative time, and hospital stay while ensuring oncologic outcomes. Despite the learning curve associated with MIS ILND, preliminary data does suggest favorable outcomes. Prospective, randomized trials are needed to reveal the full benefit of MIS ILND compared to open ILND.
阴茎癌约占美国男性癌症诊断病例的1%。区域淋巴结受累与总体预后密切相关，因此腹股沟淋巴结清扫术（ILND）对于这些患者的诊断和肿瘤治疗结果至关重要。目前开放ILND的金标准在减轻术后有害后遗症（如伤口并发症和淋巴水肿）方面存在挑战，同时又不能影响肿瘤治疗效果。对于解决开放ILND方法中所见挑战的微创（MIS）方法，人们的兴趣日益浓厚且出现了转变。文献中已探索并描述了几种不同的微创技术，如腹腔镜视频内镜腹股沟淋巴结清扫术（VEIL）和机器人辅助VEIL方法。进行了PubMed和Medline（OVID）文献综述的系统文献检索，以评估MIS方法进行ILND与传统开放方法相比的结果。关键词包括阴茎癌/阴茎肿瘤、微创手术、机器人技术、视频内镜、机器人辅助、腹股沟淋巴结清扫术和腹股沟淋巴结清扫。研究表明，MIS方法进行ILND有可能减少高级别术后并发症、手术时间和住院时间，同时确保肿瘤治疗效果。尽管MIS ILND存在学习曲线，但初步数据确实表明结果良好。需要进行前瞻性随机试验，以揭示与开放ILND相比，MIS ILND的全部益处。
