Modified Laparoscopic Inguinal Lymphadenectomy for Penile Cancer under Guidance of Layer Surgery Concept
10.11714/jsysu.med.YX20250150
- VernacularTitle:层面外科理念改良腹腔镜腹股沟淋巴结切除术治疗阴茎癌
- Author:
Yi XIA
1
;
Yao QIN
2
;
Yuhao ZHANG
1
;
Xinning WANG
1
;
Wei JIAO
1
Author Information
1. Department of Urology， The Affiliated Hospital of Qingdao University， Qingdao 266000， China
2. Department of Rehabilitation， Unit 1， Jinan Third People's Hospital， Jinan 250101， China
- Publication Type:Journal Article
- Keywords:
penile cancer;
video-endoscopic inguinal lymphadenectomy;
lymph node metastasis;
postoperative complications;
layer surgery
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2026;47(4):722-729
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the feasibility and efficacy of modified video-endoscopic inguinal lymphadenectomy （M-VEIL）， guided by the layer surgery concept， in reducing postoperative complications in patients with penile cancer. MethodsA retrospective analysis was conducted on 27 patients with penile cancer who underwent bilateral laparoscopic inguinal lymphadenectomy at the Affiliated Hospital of Qingdao University between March 2018 and March 2022. All patients had undergone prior penile surgery. M-VEIL followed a standardized four-step procedure guided by fascial planes to achieve compartment-oriented resection， with deep lymphatic trunks ligated by silk sutures and endoscopic compression suture of the skin to the muscle layer using 4-0 absorbable threads. ResultsPreoperative physical examinations and imaging findings revealed bilateral inguinal lymphadenopathy， and no distant metastases were detected in any patient. Among the 27 patients， 12 underwent traditional video-endoscopic inguinal lymphadenectomy （T-VEIL； mean age 61.08±12.75） years and 15 underwent M-VEIL （mean age 54.47±14.64） years. All 27 operations were successfully completed without conversion to open surgery. No significant differences were observed between the two groups in operative time， intraoperative blood loss， postoperative hospital stay， number of lymph nodes retrieved， or lymph node positivity rate （all P >0.05）. Drain removal time was significantly shorter in the M-VEIL group （15.93±6.89 days vs. 23.33±10.42 days； P＜0.05）. Lymphatic leakage （2 vs. 8 patients） and surgical site infection （1 vs. 6 patients） occurred less frequently in the M-VEIL group （both P ＜0.05）. No significant differences were found in lymphocele， flap necrosis， lymphedema， or lower limb edema between the two groups （all P >0.05）. During postoperative follow-up for 1-3 years， 2 patients developed pelvic lymph node metastases， while the remaining 25 showed no evidence of local or pelvic recurrence. ConclusionCompared with T-VEIL， M-VEIL appears to reduce postoperative complications and shorten drain removal time in patients undergoing inguinal lymphadenectomy for penile cancer， while providing favorable clinical outcomes. Preliminary evidence suggests that M-VEIL is a safe and feasible modified procedure.
