Abstract
Lymphatic vessels are composed of an endothelial layer surrounded by connective tissue containing scattered muscular and elastic elements. They develop in close relationship and usually follow venous structures. Together with the lymph nodes, they are the first regional barrier against malignant tumor spread. For over a century surgeons have recognized the need for and have recommended groin lymphadenectomy in patients with scrotal carcinoma: melanoma of the e~tremity:~ penile cancer:’ and vulvar carcinoma.45 Today groin dissections are indicated for malignant metastatic disease from the lower extremity, the umbilicus, the perineum and pericrural areas, the buttocks, and the external genitalia.55 Groin lymphadenectomy in combination with complete removal of the primary tumor appears to have a major therapeutic role in the management of some patients with penile, scrotal, and distal urethral carcinoma. This article discusses the regional anatomy, indications, surgical technique, and recent modifications in performing groin lymphadenectomy, with special attention to carcinoma of the penis.
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