Comparative study of video endoscopic inguinal lymphadenectomy via a hypogastric versus leg subcutaneous approach for penile cancer

To compare the efficacy and safety of video endoscopic inguinal lymphadenectomy via a hypogastric subcutaneous approach (VEIL-H) with a leg subcutaneous approach (VEIL-L) in the surgical management of penile cancer.

Between October 2012 and October 2016, 72 penile cancer patients who underwent VEIL-H (n=37) or VEIL-L (n=35) by one experienced surgeon in our hospital were retrospectively included. Data associated with demographic characteristics and peri-operative outcomes were evaluated and compared between two groups.

No intraoperative complications occurred and no deaths were recorded. No difference was noted with respect to demographic and clinicopathologic data, operative time, estimated blood loss, spare of the great saphenous vein, dissected inguinal lymph nodes, patients with inguinal lymph node metastasis, positive inguinal lymph nodes, duration of drain, postoperative hospital days, and postoperative complications between two groups (P > 0.05). Two patients of each group received a bilateral laparoscopic pelvic lymphadenectomy in one session. The pathological results of all dissected pelvic lymph nodes were negative. Median follow-up was 16.2 months during which time 3 patients in VEIL-L group and 2 patients in VEIL-H group developed regional or distant metastases.

Hypogastric approach is as effective and safe as leg subcutaneous approach in VEIL for penile cancer. Moreover, VEIL-H can avoid the operation on both the limb and abdomen if laparoscopic pelvic lymphadenectomy is required.

Journal of endourology. 2017 Dec 19 [Epub ahead of print]

Peng Yuan, Cheng Zhao, Zhizhong Liu, Zhenyu Ou, Wei He, Yuxiang Cai, Yu Wang, Xiongbin Zu, Lin Qi, Long Wang

Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Hunan Provincial Tumor Hospital and Affiliated Tumor Hospital of Xiangya Medical School, Central South University, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Pathology, Changsha, Hunan, China ; ., UPS Biological Technology Corporation, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; ., Xiangya Hospital Central South University, 159374, Department of Urology, Changsha, Hunan, China ; .