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      Comparison of antegrade robotic assisted VS laparoscopic inguinal lymphadenectomy for penile cancer

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          Abstract

          Background

          Minimally invasive modifications of inguinal lymphadenectomy (IL), including laparoscopic IL (LIL) and robotic-assisted IL (RAIL), have been utilized for penile cancer. Comparative study is necessary to guide the decision about which minimally invasive technique to select for IL. Therefore we compared RAIL with LIL performed via an antegrade approach in terms of perioperative outcomes.

          Methods

          We conducted a retrospective study of 43 patients who underwent RAIL (n = 20) or LIL (n = 23) for penile cancer from 2016 to 2020. The key surgical procedures and techniques are described. Complications were graded by the Clavien-Dindo classification, and operative time, estimated blood loss (EBL), lymph nodal yield, nodal positivity, postoperative drain duration, and disease recurrence during follow-up were assessed. Categorical variables were compared using chi-squared whereas continuous variables were compared by t-tests.

          Results

          The operative time for RAIL was significantly shorter than that of LIL (median 83 vs 95 min). Significantly less blood loss was reported with RAIL than with LIL (median 10 vs 35 ml). Lymph node yield, pathological positive nodes, the hospital stay, postoperative drain duration, postoperative complications and recurrence were similar for RAIL and LIL.

          Conclusions

          For patients with penile cancer, perioperative outcomes of RAIL and LIL were similar, but there was less blood loss, a shorter operative time for robotic cases.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12893-023-01935-6.

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          Most cited references28

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          Epidemiology and natural history of penile cancer.

          An extensive literature search was performed using the key words squamous cell carcinoma of the penis, phimosis, circumcision, chronic balanitis, cigarette smoking, genital warts and human papillomavirus (HPV) infection. All selected studies were classified according to the level of evidence (LE). The final grades of recommendation were assigned after discussion by the full panel of the International Consultation on Penile Cancer in November 2008. The factors positively associated with invasive penile cancers include the presence of phimosis (LE 3a), tobacco smoking (LE 3a-4), chewing tobacco (LE 3a), injury to the penis (LE 3a), balanitis (LE 3a), genital warts (LE 3a), and high-risk HPV infection (LE 3a-4). Copyright (c) 2010 Elsevier Inc. All rights reserved.
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            Contemporary management of patients with penile cancer and lymph node metastasis

            Leone et al. describe management strategies for patients with penile cancer and metastasis to regional lymph nodes. They review the prognostic factors, indications for lymphadenectomy, surgical techniques and the role of systemic chemotherapy, radiotherapy and new targeted and immunotherapeutic approaches.
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              Prospective study comparing video-endoscopic radical inguinal lymph node dissection (VEILND) with open radical ILND (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 ILND (OILND) in men with carcinoma of the penis.
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                Author and article information

                Contributors
                Jizheng023@163.com
                Journal
                BMC Surg
                BMC Surg
                BMC Surgery
                BioMed Central (London )
                1471-2482
                13 March 2023
                13 March 2023
                2023
                : 23
                : 55
                Affiliations
                [1 ]GRID grid.410570.7, ISNI 0000 0004 1760 6682, Department of Urology, Urologic Surgery Center, , Xinqiao Hospital, Third Military Medical University (Army Medical University), ; Chongqing, 400037 China
                [2 ]GRID grid.410570.7, ISNI 0000 0004 1760 6682, Department of Urology, , Urological Surgery Research Institute, Southwest Hospital, Third Military Medical University (Army Medical University), ; Gao Tanyan R`d. 30, Chongqing, 400038 China
                [3 ]GRID grid.416208.9, ISNI 0000 0004 1757 2259, Department of Radiology, , Southwest Hospital, Third Military Medical University (Army Medical University), ; Chongqing, China
                [4 ]GRID grid.416208.9, ISNI 0000 0004 1757 2259, Institute of Pathology and Southwest Cancer Center, , Southwest Hospital, Third Military Medical University (Army Medical University), ; Chongqing, China
                Author information
                http://orcid.org/0000-0002-4636-0998
                Article
                1935
                10.1186/s12893-023-01935-6
                10012593
                36915083
                8aa83323-38eb-48d5-bd44-d33b3cf6ac16
                © The Author(s) 2023

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 10 May 2022
                : 8 February 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100012669, Natural Science Foundation Project of Chongqing, Chongqing Science and Technology Commission;
                Award ID: cstc2021msxm3662
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100007055, Third Military Medical University;
                Award ID: CX2019LC107
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2023

                Surgery
                robotic-assisted surgery,laparoscopic surgery,penile cancer,antegrade,inguinal lymphadenectomy

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