V1697 MODIFICATIONS IN CATALONA'S TECHNIQUE OF INGUINAL LYMPH NODE DISSECTION FOR PALPABLE INGUINAL LYMPH NODES IN CARCINOMA PENIS

Abstract

You have accessJournal of UrologyOncology, Bladder Oncology1 Apr 2010V1697 MODIFICATIONS IN CATALONA'S TECHNIQUE OF INGUINAL LYMPH NODE DISSECTION FOR PALPABLE INGUINAL LYMPH NODES IN CARCINOMA PENIS Anil Mandhani Anil MandhaniAnil Mandhani More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1543AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Despite 50% of palpable lymph nodes (LNs) being benign, standard recommendation for palpable LNs in carcinoma penis is ilio-inguinal lymphadenectomy. This video describes the modification in the Catalona's technique of inguinal lymph node dissection and its efficacy in palpable LNs of less than 2 cm, which otherwise is recommended for nonpalpable inguinal LNs. METHODS From Oct 2004 to July 2009, 8 patients with palpable and mobile inguinal lymph nodes of less than 2 cm (measured on ultrasonography) had modified Catalona's lymphadenectomy. Modifications described are inclusion of Cloquet group of LN with the superficial LNs and preservation of fascia lata (which is dissected in Catalona's technique).Fascia lata was opened and subsequent pelvic node was done only when either superficial or Cloquet group of LNs were positive on frozen section. Exclusion criteria for this approach were – large (more than 2 cm size), fixed, ulcerated or fungating LN. Primary outcome noted was recurrence free survival. Secondary outcome measured was complications of LN dissection. RESULTS Median size of the palpable inguinal LNs was 1.7cm (1.5to 2cm). All patients were alive at a mean follow up of 36 (1-57) months with no evidence of disease recurrence. Two of 8 patients had positive LN on frozen section, who then had pelvic LN dissection. Finding on frozen section were consistent with the final histopathology. Two patients had necrosis of margins of the flaps at the incision site, which healed on conservative treatment without any functional deformity or a need for any reconstruction. CONCLUSIONS In a select group of patients of carcinoma penis with 1-2 cm palpable inguinal lymph nodes, Catalona's inguinal lymphadenectomy with its modification seems to be a reasonable alternative to standard ilio-inguinal lymphadenectomy. Lucknow, India© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e655 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Anil Mandhani More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...