Robot-assisted inguinal lymphadenectomy to treat penile and vulvar cancers: a scoping review.

IF 4.9 2区 医学 Q1 UROLOGY & NEPHROLOGY Minerva Urology and Nephrology Pub Date : 2024-06-01 DOI:10.23736/S2724-6051.24.05532-0
Aldo Brassetti, Giuseppe Chiacchio, Umberto Anceschi, Alfredo Bove, Mariaconsiglia Ferriero, Simone D'Annunzio, Leonardo Misuraca, Salvatore Guaglianone, Gabriele Tuderti, Riccardo Mastroianni, Francesco Tedesco, Loris Cacciatore, Flavia Proietti, Simone R Flammia, Cosimo De Nunzio, Gabriele Cozzi, Costantino Leonardo, Andrea B Galosi, Giuseppe Simone
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Abstract

Introduction: Inguinal lymph nodes dissection (ILND) is recommended in patients presenting with high-risk penile (PC) or vulvar cancers (VC). Though, this surgical procedure is underused because of its anticipated morbidity. Minimally invasive approaches were proposed to minimize complications associated with open surgery. In this review, we analyze current available data exploring intra and perioperative outcomes of robot-assisted ILND (RAIL).

Evidence acquisition: On April 9th, 2023, a literature search was conducted using the PubMed and Scopus databases. The search employed the combination of the following terms: ("robotic assisted" OR "robot-assisted" OR "robotic") AND ("inguinal lymph node dissection" OR "lymphadenectomy") AND ("penile cancer" OR "vulvar cancer"). Out of the 404 identified articles, 18 were used for the present scoping review and their results were reported according to the PRISMA statement.

Evidence synthesis: Data on 171 patients, ranging in age from 32 to 85 years, were obtained. Most of them (90.6%) harbored a penile squamous cell carcinoma and presented with no palpable nodes (85%). Operation time (OT) ranged between 45 and 300 min. Estimated blood loss varied from 10 to 300 mL. One single intra-operative complication was reported and one conversion to open was recorded. The lymph nodes (LNs) count spanned from 3 to 26 per groin, with 17 studies reporting a median yield >7 nodes. Hospital stay was 1-7 days, while the duration of drainage ranged from 4 to 72 days. Post-operative complications included lymphocele (22.2%; 0-100%), lymphedema (13.4%; 0-40%), cellulitis (11.1%; 0-25%), skin necrosis (8.7%; 0-15.4%). seroma (3.5%; 0-20%) and wound breakdown/wound infection (2.9%; 0-10%). Out of the included studies, 7 provided at least a 12-month follow-up, with recurrence-free rates ranging from 50% to 100% in patients affected by penile cancer and from 92% to 100% in vulvar cancer patients.

Conclusions: The available evidence on RAIL for the treatment of PC and VC is limited. The approach appears to be safe and effective, as it provides an adequate lymph node yield while ensuring a minimally morbid postoperative course and a short hospital stay.

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机器人辅助腹股沟淋巴结切除术治疗阴茎癌和外阴癌:范围界定综述。
简介:高危阴茎癌(PC)或外阴癌(VC)患者建议进行腹股沟淋巴结清扫术(ILND)。然而,由于其预期的发病率,这种手术方法的使用率并不高。为了最大限度地减少与开放手术相关的并发症,人们提出了微创方法。在这篇综述中,我们分析了探讨机器人辅助ILND(RAIL)术中和围手术期结果的现有数据:2023 年 4 月 9 日,我们使用 PubMed 和 Scopus 数据库进行了文献检索。检索采用了以下术语组合:("机器人辅助 "或 "机器人辅助 "或 "机器人")和("腹股沟淋巴结清扫术 "或 "淋巴结切除术")和("阴茎癌 "或 "外阴癌")。在确定的 404 篇文章中,有 18 篇用于本次范围界定综述,其结果按照 PRISMA 声明进行了报告:获得了 171 名患者的数据,患者年龄从 32 岁到 85 岁不等。其中大部分患者(90.6%)患有阴茎鳞状细胞癌,且无可触及的结节(85%)。手术时间(OT)从 45 分钟到 300 分钟不等。估计失血量从 10 毫升到 300 毫升不等。报告了一起术中并发症,记录了一起转为开放手术的病例。腹股沟淋巴结(LNs)数量从3到26个不等,其中17项研究报告的中位数大于7个。住院时间为 1-7 天,引流时间为 4-72 天。术后并发症包括淋巴肿(22.2%;0-100%)、淋巴水肿(13.4%;0-40%)、蜂窝组织炎(11.1%;0-25%)、皮肤坏死(8.7%;0-15.4%)、血清肿(3.5%;0-20%)和伤口破裂/伤口感染(2.9%;0-10%)。在纳入的研究中,有7项提供了至少12个月的随访,阴茎癌患者的无复发率从50%到100%不等,外阴癌患者的无复发率从92%到100%不等:关于 RAIL 治疗 PC 和 VC 的现有证据有限。结论:RAIL 治疗 PC 和 VC 的现有证据有限,但这种方法似乎安全有效,因为它既能获得足够的淋巴结,又能确保术后病程短、住院时间短。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Minerva Urology and Nephrology
Minerva Urology and Nephrology UROLOGY & NEPHROLOGY-
CiteScore
8.50
自引率
32.70%
发文量
237
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