Factor associated with postoperative complications of inguinal lymph node dissection for penile cancer Test.

IF 0.7 Q4 UROLOGY & NEPHROLOGY Urology Annals Pub Date : 2024-10-01 Epub Date: 2024-10-16 DOI:10.4103/ua.ua_26_24

Phatsinee Likitpanpisit, Satit Siriboonrid

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Abstract

Background: Inguinal lymph node dissection (ILND) is the standard of care for palpable, biopsy-proven lymph node metastases or high-risk groups for nonpalpable lymph nodes in the treatment of penile cancer. ILND is associated with a significant incidence of complications and adverse events, specifically wound complications. Few studies have identified risk factors related to postoperative ILND complications.

Objective: The objective of this study was to assess the prevalence of 30-day postoperative complications and to identify risk factors associated with postoperative complications of ILND for penile cancer.

Materials and methods: This was a retrospective review of medical records for all patients who had ILND for penile cancer between January 2012 and December 2022. According to the modified Clavien-Dindo classification, the 30-day postoperative complications were collected. Using an ordinal univariate logistic regression model and multivariate analysis, potential risk variables for complications were determined.

Results: A total of 60 patients were performed ILND. Sixty percent of the patients had a postoperative complication including wound infection 50%, wound dehiscence 36.7%, skin necrosis 26.6%, lymphocele 33.3%, leg edema 46.7%, and scrotal edema 16.7%. Higher grade of modified Clavien-Dindo classification was associated with body mass index (BMI) (odds ratio [OR] = 1.15; P = 0.03), diabetes mellitus (OR = 3.13; P = 0.04), American Society of Anesthesiologist classification ≥3 (OR = 1.14; P = 0.03), radical ILND (OR = 1.57; P = 0.01), and bilateral ILND (OR = 1.60; P = 0.02). In multivariate analysis, a higher grade of modified Clavien-Dindo classification was correlated with BMI (OR = 1.48; P = 0.01) and bilateral ILND (OR = 4.56; P = 0.01).

Conclusion: ILND is associated with high rates of complication. The severity of the modified Clavien-Dindo classification was associated with BMI and bilateral ILND.

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阴茎癌腹股沟淋巴结清扫术术后并发症的相关因素试验。

背景：腹股沟淋巴结清扫术（ILND）是治疗阴茎癌中可触及的、活检证实的淋巴结转移或不可触及淋巴结的高危人群的标准治疗方法。ILND 与并发症和不良事件（尤其是伤口并发症）的高发生率有关。很少有研究发现与ILND术后并发症相关的风险因素：本研究旨在评估阴茎癌ILND术后30天并发症的发生率，并确定与术后并发症相关的风险因素：本研究对2012年1月至2022年12月期间所有阴茎癌ILND患者的病历进行了回顾性分析。根据改良的Clavien-Dindo分类法，收集了术后30天的并发症。通过顺序单变量逻辑回归模型和多变量分析，确定了并发症的潜在风险变量：结果：共有60名患者接受了ILND手术。结果：共有60名患者接受了ILND手术，其中60%的患者术后出现并发症，包括伤口感染50%、伤口裂开36.7%、皮肤坏死26.6%、淋巴结肿大33.3%、腿部水肿46.7%和阴囊水肿16.7%。改良的 Clavien-Dindo 分级较高与体重指数（BMI）（比值比 [OR] = 1.15；P = 0.03）、糖尿病（OR = 3.13；P = 0.04）、美国麻醉医师协会分类≥3（OR = 1.14；P = 0.03）、根治性 ILND（OR = 1.57；P = 0.01）和双侧 ILND（OR = 1.60；P = 0.02）相关。在多变量分析中，改良的 Clavien-Dindo 分级越高与体重指数（OR = 1.48；P = 0.01）和双侧 ILND（OR = 4.56；P = 0.01）相关：结论：ILND的并发症发生率较高。结论：ILND与高并发症发生率有关，改良的Clavien-Dindo分类的严重程度与体重指数和双侧ILND有关。

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