Open inguinal lymph node dissection (OILND) plays a crucial role in penile cancer management, but in order to improve patient outcomes, minimally-invasive (MILND) approaches were developed. Our "bottoms-up" MILND is a novel endoscopic technique, changing the way the sequence of dissection is performed. This study aims to compare our approach to the current standard of OILND in terms of oncologic and perioperative outcomes.
In our database, from 2016 to 2023, 12 patients underwent OILND and 16 had a "bottoms-up" MILND, which is performed with a three port configuration, starting the dissection under the fascia lata, dissecting the femoral vessels in the most distal part of the femoral fossa, followed by dissection of the proximal and superficial lymph nodes at the top of thefemoral triangle.
For MILND, median operation time per groin was shorter (58 vs 64 minutes, p=0.34), patients presented shorter hospital stays (10 vs 18 days, p=0.32) and fewer days with drains (14 vs 24 days, p=0.01). Median lymph node yield per groin was higher for MILND (10 vs 9 nodes, p=0.7), but OILND had a higher median of positive lymph nodes (4 vs 3 nodes, p=0.63). MILND patients experienced a lower incidence of major complications (33% vs 58%, p=0.007).
We have proved that our technique of MILND is not inferior to the current standard and we believe that it can further improve patient outcomes with a safer, simplified and easily reproducible approach.
Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica. 2024 Oct 02*** epublish ***
Vlad-Horia Schițcu, Vlad Cristian Munteanu, Mihnea Bogdan Borz, Ion Cojocaru, Sergiu Vasile Labo, Andrei-Ionut Tise
Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. ., Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. ., Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. ., Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. ., Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. ., Department of Urology, Institute of Oncology "Prof. Dr. Ion Chiricuţă", Cluj-Napoca. .