Management of patients with penile cancer (PeC) with palpable inguinal lymph nodes (ILNs) relies on radical ILN dissection (RILND). Low burden of nodal metastatic disease may lead to long-lasting survival with surgical management.
Nevertheless, RILND involves significant postoperative morbidity. We compared the complications of patients undergoing RILND with (RILND-T) and without (RILND-0T) placement of a collagen-fibrin sealant patch on the resection bed.
We conducted an observational retrospective study. Data from men submitted to RILND-T and RILND-0T from Jan/2001 to Feb/2022, in a tertiary care centre were compared. The primary endpoint was the overall incidence of complications until 1 month after the procedure and their respective severity in both cohorts (Clavien-Dindo classification system). Secondarily, length of hospital stay (LOHS) was analysed. The placement of a collagen-fibrin sealant patch was left at the surgeon's discretion.
Seven patients underwent RILND-T and 20 underwent RILND-0T, respectively. There were no differences in pathologic TNM stage nor in the total number of ILNs removed (17 ± 4 vs. 20 ± 8, p = 0.37). Overall, 23 (85.2%) patients had complications. The complication rate was similar in both cohorts (85.7% vs 85%, p = 0.73). Surgical wound infection (3/7 vs. 11/20) and lymphocele (4/7 vs. 11/20) were the most reported complications. Patients undergoing RILND-T were discharged faster (mean length of hospital stay 9 ± 3 vs 19 ± 20 days, p = 0.22).
The application of a collagen-fibrin sealant patch on the resection bed does not seem to reduce the postoperative complication rate in patients undergoing RILND. Nevertheless, a trend towards a shorter LOHS in patients with RILND-T cannot be excluded and should be validated by further studies with a higher number of patients.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2022 Dec 27*** epublish ***
Andreia Bilé Silva, João Nuno Pereira, Rui Freitas, Isaac Braga, João Carvalho, José Sanches Magalhães, Vítor Silva, Francisco Lobo, António Morais
Hospital de Egas Moniz - Centro Hospitalar de Lisboa Ocidental, Lisboa. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. ., Instituto Português de Oncologia Francisco Gentil do Porto, Porto. .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36576475