https://doi.org/10.4081/aiua.2022.4.434

Does the placement of a collagen-fibrin sealant reduce complications of radical inguinal lymph node dissection? - Comparative study in patients with penile cancer

Vol. 94 No. 4 (2022)
Submitted: August 7, 2022
Accepted: August 21, 2022
Published: December 27, 2022
Penile Cancer, Radical Inguinal Lymph Node Disssection, Radical Inguinal Lymph Node Lymphadenectomy, Complications Of Radical Inguinal Lymph Node Disssection
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Authors

Andreia Bilé Silva
andreiabile@campus.ul.pt
Hospital de Egas Moniz - Centro Hospitalar de Lisboa Ocidental, Lisboa, Portugal.
João Nuno Pereira
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
Rui Freitas
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
Isaac Braga
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
João Carvalho
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
José Sanches Magalhães
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
Vítor Silva
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
Francisco Lobo
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.
António Morais
Instituto Português de Oncologia Francisco Gentil do Porto, Porto, Portugal.

Objective: Management of patients with penile cancer (PeC) with palpable inguinal lymph nodes (ILNs) relies on radical ILN dissection (RILND). Low burden of nodal metastatic disease may lead to long-lasting survival with surgical management. Nevertheless, RILND involves significant postoperative morbidity. We compared the complications of patients undergoing RILND with (RILND-T) and without (RILND-0T) placement of a collagen-fibrin sealant patch on the resection bed.
Materials and methods: We conducted an observational retrospective study. Data from men submitted to RILND-T and RILND-0T from Jan/2001 to Feb/2022, in a tertiary care centre were compared. The primary endpoint was the overall incidence of complications until 1 month after the procedure and their respective severity in both cohorts (Clavien-Dindo classification system). Secondarily, length of hospital stay (LOHS) was analysed. The placement of a collagen-fibrin sealant patch was left at the surgeon’s discretion.
Results: Seven patients underwent RILND-T and 20 underwent RILND-0T, respectively. There were no differences in pathologic TNM stage nor in the total number of ILNs removed (17 ± 4 vs. 20 ± 8, p = 0.37). Overall, 23 (85.2%) patients had complications. The complication rate was similar in both cohorts (85.7% vs 85%, p = 0.73). Surgical wound infection (3/7 vs. 11/20) and lymphocele (4/7 vs. 11/20) were the most reported complications. Patients undergoing RILND-T were discharged faster (mean length of hospital stay 9 ± 3 vs 19 ± 20 days, p = 0.22).
Conclusions: The application of a collagen-fibrin sealant patch on the resection bed does not seem to reduce the postoperative complication rate in patients undergoing RILND. Nevertheless, a trend towards a shorter LOHS in patients with RILND-T cannot be excluded and should be validated by further studies with a higher number of patients.

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How to Cite

Silva, A. B., Pereira, J. N., Freitas, R., Braga, I., Carvalho, J., Magalhães, J. S., Silva, V., Lobo, F., & Morais, A. (2022). Does the placement of a collagen-fibrin sealant reduce complications of radical inguinal lymph node dissection? - Comparative study in patients with penile cancer. Archivio Italiano Di Urologia E Andrologia, 94(4), 434–438. https://doi.org/10.4081/aiua.2022.4.434
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