PD34-09 SURGICAL AND ONCOLOGICAL OUTOCMES AFTER VIDEO ENDOSCOPIC INGUINAL LYMPHADENECTOMY (VEIL): SINGLE INSTITUTE SERIES

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease I1 Apr 2016PD34-09 SURGICAL AND ONCOLOGICAL OUTOCMES AFTER VIDEO ENDOSCOPIC INGUINAL LYMPHADENECTOMY (VEIL): SINGLE INSTITUTE SERIES Yuvaraja Thyavihally, Nikhil Dharmadhikari, Abhinav Pednekar, Harshvardhan Rao, Nikhil Gulavani, Mrunal Parab, Tirathram Kaushik, Amit Patil, Kalyan Chakradhar, and Santosh Waigaonkar Yuvaraja ThyavihallyYuvaraja Thyavihally More articles by this author , Nikhil DharmadhikariNikhil Dharmadhikari More articles by this author , Abhinav PednekarAbhinav Pednekar More articles by this author , Harshvardhan RaoHarshvardhan Rao More articles by this author , Nikhil GulavaniNikhil Gulavani More articles by this author , Mrunal ParabMrunal Parab More articles by this author , Tirathram KaushikTirathram Kaushik More articles by this author , Amit PatilAmit Patil More articles by this author , Kalyan ChakradharKalyan Chakradhar More articles by this author , and Santosh WaigaonkarSantosh Waigaonkar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.994AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Groin lymph node dissection (GND) in carcinoma of penis is associated with high incidence of wound related complications like flap necrosis, infection etc. VEIL is a surgical technique with the same template of the open GND but performed with laparoscopic or robotic instruments. We present our experience VEIL and present surgical outcomes and long term follow up to know oncological safety of this procedure. METHODS From Aug 2007 to May 2015, we have performed VEIL on 41 patients (7 bilateral) and 48 groins. Pure laparoscopic VEIL (L-VEIL) was done on 19 patients (3 bilateral) and 22 groins whereas Robot assisted VEIL (R-VEIL) was performed on 22 patients (4 bilateral) and 26 groins. The indications for VEIL was clinically N0 groin in high risk primary and positive nodes <3 cms in size. Five patients of R-VEIL also had saphenous vein sparing surgery. 38 groins had clinically negative groin with intermediate and high risk penile cancer and 10 groins had N1 nodes less than 3 cms in size. Mean follow up of these patients was 5 years (range, 6 months – 8 years). RESULTS Mean age of the patients was 53 years (range,42-68 years). Mean operative time was 160 mts (110-240) for L-VEIL and 110 mts (Range 70 -210) for R-VEIL. Blood loss was 50 ml (Range 30-100ml). There were no intraoperative complications. None of the patient had wound related complications like necrosis, infection. Average time for lymphorrheoa to stop was 17 days (Range- 10-23 days). Six patients had lymphocele which required repeated aspiration. Four patients had long term mild to moderate lymph edema. With mean follow up of 5 years one patient developed nodal recurrence who had pathologically negative nodes (25 groina) [4%]. Out of 23 groins who had positive nodes on histopathology, one patient developed local penile recurrence and another inguinal nodal recurrence (8.6%). One developed para-aortic lymph node metastasis and died of disease. CONCLUSIONS VEIL is safe and technically feasible option in managing N0 and N1 inguinal lymph nodes in carcinoma penis avoiding flap related complications while maintaining oncological principles. Both laparoscopic and robotic approaches are suitable with later method having advantages of vision and intuitive motion. Our long term follow up study shows VEIL is oncologically safe procedure limited only by numbers as this is a rare disease. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e842 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Yuvaraja Thyavihally More articles by this author Nikhil Dharmadhikari More articles by this author Abhinav Pednekar More articles by this author Harshvardhan Rao More articles by this author Nikhil Gulavani More articles by this author Mrunal Parab More articles by this author Tirathram Kaushik More articles by this author Amit Patil More articles by this author Kalyan Chakradhar More articles by this author Santosh Waigaonkar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...