Robotic-Assisted Video-Endoscopic Inguinal Lymphadenectomy (RAVEIL) and Video-Endoscopic Inguinal Lymphadenectomy (VEIL) versus Open Inguinal Lymph-Node Dissection (OILND) in carcinoma of penis: Comparison of perioperative outcomes, complications and oncological outcomes. A systematic review and meta-analysis

Objective: To report outcomes from the largest multicenter series of penile cancer patients undergoing video endoscopic inguinal lymphadenectomy (VEIL). Materials and Methods: Retrospective multicenter analysis. Authors of 21 centers from the Penile Cancer Collaborative Coalition-Latin America (PeC-LA) were included. All centers performed the procedure following the same previously described standardized technique. Inclusion criteria included penile cancer patients with no palpable lymph nodes and intermediate/high-risk disease and those with non-fixed palpable lymph nodes less than 4 cm in diameter. Categorical variables are shown as percentages and frequencies whereas continuous variables as mean and range. Results: From 2006 to 2020, 210 VEIL procedures were performed in 105 patients. Mean age was 58 (45-68) years old. Mean operative time was 90 minutes (60-120). Mean lymph node yield was 10 nodes (6-16). Complication rate was 15.7%, including severe complications in 1.9% of procedures. Lymphatic and skin complications were noted in 8.6 and 4.8% of patients, respectively. Histopathological analysis revealed lymph node involvement in 26.7% of patients with non-palpable nodes. Inguinal recurrence was observed in 2.8% of patients. 10y- overall survival was 74.2% and 10-y cancer specific survival was 84.8%. CSS for pN0, pN1, pN2 and pN3 were 100%, 82.4%, 72.7% and 9.1%, respectively. Conclusion: VEIL seems to offer appropriate long term oncological control with minimal morbidity. In the absence of non-invasive stratification measures such as dynamic sentinel node biopsy, VEIL emerged as the alternative for the management of non-bulky lymph nodes in penile cancer.

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“…Oncological outcomes were similar in a short-term follow-up ( 25 ). Other two systematic reviews confirmed these results ( 26 , 27 ).…”

Section: Discussionsupporting

confidence: 54%

“…In the last few years, we have observed an increase in the adoption of a Robotic Assisted- VEIL (R-VEIL) approach, probably stimulated by a seemingly shorter learning curve when compared to pure laparoscopic VEIL ( 19 , 27 ). Currently R-VEIL and conventional VEIL outcomes seem to be quite comparable.…”

Section: Discussionmentioning

confidence: 99%

Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer

et al. 2023

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“…Des-de los primeros reportes de casos exitosos de LIE por Tobías Machado (Brasil, 2006) y Rene Sotelo (Venezuela, 2007), (2,3) los múltiples trabajos demuestran las ventajas de esta técnica, con menor morbilidad y pronta recuperación funcional, además de resultados oncológicos similares a la técnica convencional. (9,(12)(13)(14) La LIE puede ser pura. (2)(3)(4)9,10) o con asistencia robótica, (15)(16)(17) utilizando uno (un solo puerto) o más trocares, (18) colocándolos en la región hipogástrica o crural (a nivel del vértice del triángulo crural o lateral al músculo sartorio), (19)(20)(21) realizándola una después de otra o en simultáneo, (22,23) utilizando CO2 o equipos de tracción externa para crear el espacio de trabajo y finalmente iniciando la disección de la pieza operatoria superficialmente a nivel de la fascia de Scarpa o profundamente entre el músculo y el tejido celular.…”

Section: Discussionunclassified

“…(5) Este resultado de 26% es similar a los encontrados en revisiones sistemáticas y estadísticamente menor al de la LC. (9,14) En todos los casos la recuperación fue a corto plazo con un promedio de estancia hospitalaria de 8 días.…”

Section: Discussionunclassified

Linfadenectomía inguinal endoscópica en cáncer de pene: resultados oncológicos, funcionales y morbilidad a largo plazo

et al. 2022

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Objetivo: Presentar nuestra experiencia usando linfadenectomía inguinal endoscópica (LIE) en el manejo del cáncer de pene con factores de riesgo para metástasis y ganglios inguinales clínicamente negativos (cN0); evaluar los resultados obtenidos a largo plazo y con los descritos en la revisión de la literatura plantear “objetivos ideales” para esta técnica mínimamente invasiva. Metodología: Entre el 2012 y 2016, pacientes con diagnóstico de cáncer de pene que cumplieron los criterios de patología mayor a pT1G2 y ganglios inguinales cN0, fueron sometido a LIE. Registramos datos prequirúrgicos, perioperatorios, anatomo-patológicos y de seguimiento. Analizamos resultados y discutimos la evidencia descrita en la revisión de la literatura. Resultados: En 15 pacientes con una media de 59 años, se realizaron 23 LIE (08 bilaterales y 07 unilaterales). El tiempo operatorio promedio fue 126 minutos; todos los casos con sangrado menor a 50 cc. La media de ganglios disecados por región inguinal fue 10.4; en 3 pacientes se encontró 1 ganglio metastásico. No se presentaron complicaciones Clavien-Dindo III o IV. Durante el periodo de seguimiento promedio de 89 meses (rango 72-120), ningún paciente presentó recurrencia o progresión de enfermedad. Conclusiones: La evaluación a largo plazo en este grupo de pacientes ha mostrado ser una alternativa efectiva, segura y reproducible con resultados óptimos en control oncológico, pronta recuperación funcional y mínimas complicaciones intra y postoperatorias. Las diversas publicaciones coinciden en afirmar que tiene ventajas en comparación a la convencional, cumpliendo estos tres “objetivos ideales” que calificamos como trifecta, similar al concepto usado en otras cirugías uroncológicas.

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“…Tobias Machado performed video endoscopic inguinal lymphadenectomy (VEIL) in 2005 ( 6 ). VEIL has less trauma, skin complications, lymphedema, hospital stay, duration of drainage, and better lymph node yield than open operation ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic simultaneous anterograde inguinal and pelvic lymphadenectomy for penile cancer: two planses, three holes, and six steps

Yi,

Li,

et al. 2024

Front. Surg.

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ObjectiveTo assess the feasibility, safety, and efficiency of simultaneous anterograde video laparoscopic inguinal and pelvic lymphadenectomy for penile cancer.Materials and methodsWe reviewed retrospectively the records of 22 patients (44 lateral) who underwent inguinal lymph nodes dissection for penile cancer. The procedure was standardized as two planes, three holes, and six steps. Two Separate-planes: superior plane of eternal oblique aponeurosis/ / fascia lata; inferior plane of superficial camper fascia. Three holes: two artificial lateral boundary holes, the internal and external boundary holes, and the hole of oval fossa. Six steps: separate the first separate-plane; separate the second layer; separate two artificial lateral boundary holes; free great saphenous vein; separate the third hole and clean up the deep inguinal lymph nodes; pelvic lymphadenectomy.ResultsA total of 22 cases were included and 9 patients underwent simultaneous pelvic lymphadenectomy. The average operation time on both sides was 7.52 ± 3.29 h, which was 0.5–1 h/side after skilled. The average amount of bleeding was 93.18 ± 50.84 ml. A total of 8 patients had postoperative complications, accounting for 36.36%, and no complications great than Clavien-Dindo class III occurred.ConclusionThis study demonstrated that the video laparoscopic simultaneous anterograde inguinal and pelvic lymphadenectomy is a feasible and safe technique. Indocyanine Green was helpful for lymph node identify.

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Cited by 17 publications

References 39 publications

Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer

Long-term oncological and surgical outcomes after Video Endoscopic Inguinal Lymphadenectomy (VEIL) in patients with penile cancer

Linfadenectomía inguinal endoscópica en cáncer de pene: resultados oncológicos, funcionales y morbilidad a largo plazo

Laparoscopic simultaneous anterograde inguinal and pelvic lymphadenectomy for penile cancer: two planses, three holes, and six steps

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