Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Schwentner, C; Todenhöfer, T; Seibold, J; Alloussi, SH; Mischinger, J; Aufderklamm, S; Stenzl, A; Gakis, G.
Endoscopic inguinofemoral lymphadenectomy--extended follow-up.
J Endourol. 2013; 27(4):497-503
Doi: 10.1089/end.2012.0489
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Mischinger Johannes
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- Abstract:
- Inguinofemoral lymphadenectomy (IFLA) is a standard procedure for cancer of the external genitalia. Open lymphadenectomy (O-IFLA) exhibits complication rates of more than 50%. We are demonstrating our extended experience with a modified endoscopic approach (E-IFLA) for groin lymphadenectomy. Patients with nonpalpable as well as those with palpable nodes who had IFLA were identified. O-IFLA comprised both superficial and deep inguinal lymph node dissection. E-IFLA was performed using a three-trocar approach in the same field. We used a reduced CO2-pressure of <5 mm Hg. A suction drain was always placed. Perioperative data and postoperative outcomes were systematically assessed followed by statistical analysis. We performed 62 IFLAs in 42 patients. Twenty-eight procedures were completed endoscopically. Follow-up was 55.8 months (2-87 mos). Mean operative time for O-IFLA was 101.7 minutes (38-195 min), being shorter than for E-IFLA (136.3 min, 87-186 min), P<0.001. Both groups are comparable regarding the number of nodes (O-IFLA 7.2, 2-16 vs E-IFLA 7.1, 4-13) as well as with regard to the number of positive nodes (O-IFLA 1.8 vs E-IFLA 1.6). Secondary wound healing and leg edema were extremely rare events (1/28) after E-IFLA. The overall complication rate was 7.1%. Complications appeared in 55.3% of the O-IFLA-cases. There were no problems related to CO2 insufflation. Local recurrence rates were identical in both groups. O-IFLA and E-IFLA are efficient with respect to oncologic safety. E-IFLA is technically more challenging. E-IFLA can avoid secondary wound healing and lymphatic complications. E-IFLA is a safe procedure while a reduction of CO2 pressures optimizes the safety profile. Because cancer control rates remained equivalent during an extended follow-up, oncologic durability could be confirmed.
- Find related publications in this database (using NLM MeSH Indexing)
- Anatomic Landmarks -
- Dissection -
- Endoscopy -
- Fasciotomy -
- Femoral Artery - pathology
- Femoral Artery - surgery
- Femur - blood supply
- Femur - pathology
- Femur - surgery
- Follow-Up Studies -
- Humans -
- Inguinal Canal - pathology
- Inguinal Canal - surgery
- Lymph Node Excision - methods
- Male -
- Middle Aged -
- Patient Positioning -
- Saphenous Vein - pathology
- Saphenous Vein - surgery
- Supine Position -
- Surgical Instruments -