A New Surgical Technique of Laparoscopic Retrograde Inguinal Lymph Node Dissection: Our Initial Experience

Abstract

Background To explore the clinical efficacy of a new laparoscopic inguinal retrograde lymph node dissection (LND) in treating penile cancer and scrotal Paget’s disease. Methods 12 patients with penile cancer and 1 with scrotal Paget’s disease admitted and treated with laparoscopic retrograde inguinal LND in two medical centers from July 2018 to September 2020 were retrospectively analyzed. Thereafter, the basic clinical data, operation time, intraoperative blood loss, number of harvested lymph nodes and postoperative complications were evaluated. Results 13 patients were performed laparoscopic retrograde inguinal LND successfully under general anesthesia. Among them, 4 cases received pelvic lymph node dissection (PLND) simultaneously through the same incision. The operation time was (220.00±33.73) min, and the intraoperative blood loss was (15.38±13.76) ml. (8.92士4.00) lymph nodes were harvested in the left groin, (8.54士5.04) lymph nodes were dissected in the right groin. Meanwhile, (5.00士1.00) lymph nodes were harvested in the left pelvic cavity, and (8.50± 6.46) lymph nodes were dissected in the right pelvic cavity. All the 13 cases were successfully operated without conversions to open surgery. One case developed mild blister in subcutaneous skin, two had mild lower limb swelling, and one had lymph leakage; all these patients recovered favorably after symptomatic treatment, with no other surgery-related complications. The drainage tube removal time lasted for (13.23士3.83) days. The postoperative follow-up time ranged from 2.5 to 19.5 months, and no primary lesion, inguinal or pelvic lymph node relapse or metastasis was reported. Conclusion Laparoscopic retrograde inguinal LND can be applied to treat penile cancer and scrotal Paget’s disease, and it is safe and effective. Moreover, inguinal LND and PLND can be performed through the same incision, which is worthy of being promoted in clinic.