Prospective study comparing Videoendoscopic radical Inguinal Lymph node dissection (VEILND) with Open radical inguinal lymphnode dissection (OILND) for penile cancer over an 8 year period

To compare the complications and oncological outcomes between Video Endoscopic Inguinal Lymph node Dissection (VEILND) and Open Inguinal Lymph node Dissection (OILND) in men with carcinoma of the penis.

A prospectively collected institutional database was used to determine the outcomes in 42 consecutive patients undergoing inguinal lymph node dissection between 2008 and 2015 in a centre for treating penile cancer. Before 2013 all procedures involved open surgery. Since 2013 we have performed VEILND on all patients in need of ILND. The wound related, non-wound related complications, length of stay and oncological safety between OILND and VEILND groups were compared. The mean duration of follow up was 71months for OILND and 16 months for the VEILND groups.

In the study period 42 patients underwent 68 inguinal node dissections (open 35, video-assisted 33). The patients demographics, primary stage and grade, indications were comparable in both the groups. There were no intraoperative complications in either group. The wound complication rate was significantly lower in VEILND group at 6% compared to 68% in the OILND group. Lymphocele rates were similar in both the groups (27 and 20%). The VEILND group showed better or same lymph node yield, mean number of positive lymph nodes and lymph node density confirming oncological safety. There were no groin recurrence in either group of patients. VEILND patients had significant reduced length of stay by 4.9 days (p=0.0001).

VEILND is an oncologically safe procedure with considerably low morbidity and reduced length of stay at a mean follow-up of 16 months (Range: 4-35 months). This article is protected by copyright. All rights reserved.

BJU international. 2016 Sep 15 [Epub ahead of print]

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Vivekanandan Kumar, Krishna K Sethia

Norfolk and Norwich University Hospital, Norwich, United Kingdom. ., Norfolk and Norwich University Hospital, Norwich, United Kingdom.