5438307e753cfae144f20ba8872fbc80 296601.pdf e94f1f1026f9d0cc62cad5ded97f450fb3feabfb 296601.pdf c05eb79f646eb29c51d54a34aa2e1403a215796d3eeee36ff84ef86a723bf8a3 296601.pdf Title: Simultaneous Bilateral Video–Endoscopic Inguinal Lymphadenectomy for Penile Carcinoma: Surgical Setting, Feasibility, Safety, and Preliminary Oncological Outcomes Subject: Introduction: Inguinal lymph node dissection (ILND) plays an important role for both staging and treatment purposes in patients diagnosed with penile carcinoma (PeCa). Video–endoscopic inguinal lymphadenectomy (VEIL) has been introduced to reduce complications, and in those patients elected for bilateral ILND, a simultaneous bilateral VEIL (sB-VEIL) has also been proposed. This study aimed to investigate the feasibility, safety, and preliminary oncological outcomes of sB-VEIL compared to consecutive bilateral VEIL (cB-VEIL). Material and methods: Clinical N0-2 patients diagnosed with PeCa and treated with cB-VEIL and sB-VEIL between 2015 and 2023 at our institution were included. Modified ILND was performed in cN0 patients, while cN+ patients underwent a radical approach. Intra- and postoperative complications, operative time, time of drainage maintenance, length of hospital stay and readmission within 90 days, as well as lymph node yield, were compared between the two groups. Results: Overall, 30 patients were submitted to B-VEIL. Of these, 20 and 10 patients underwent cB-VEIL and sB-VEIL, respectively. Overall, 16 (80%) and 7 (70%) patients were submitted to radical ILND due to cN1-2 disease in the cB-VEIL and sB-VEIL groups, respectively. No statistically significant difference emerged in terms of median nodal yield (13.5 vs. 14, p = 0.7) and median positive LNs (p = 0.9). sD-VEIL was associated with a shorter operative time (170 vs. 240 min, p < 0.01). No statistically significant difference emerged in terms of intraoperative estimated blood loss, length of hospital stay, time to drainage tube removal, major complications, and hospital readmission in the cB-VEIL and sB-VEIL groups, respectively (all p > 0.05). Conclusions: Simultaneous bilateral VEIL is a feasible and safe technique in patients with PeCA, showing similar oncological results and shorter operative time compared to a consecutive bilateral approach. Patients with higher preoperative comorbidity burden or anesthesiological risk are those who may benefit the most from this technique. Keywords: penile carcinoma; video–endoscopic inguinal lymphadenectomy; inguinal lymph node dissection; minimally invasive surgery; invasive inguinal staging Author: Josep M. Gaya, Giuseppe Basile, Pavel Gavrilov, Andrea Gallioli, Angelo Territo, Jorge Robalino, Pedro Hernandez, Raul Sanchez-Molina, Alejandra Bravo, Ferran Algaba, Jordi Huguet, Francesco Sanguedolce, Joan Palou, Antonio Rosales and Alberto Breda Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Nov 24 08:47:49 2023 CET ModDate: Fri Nov 24 08:58:46 2023 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 11 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1317538 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- GMZEJB+VnURWPalladioL Type 1 Custom yes yes no 10 0 WLDZGB+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 RFUEOZ+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 MLRUJF+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 42 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 45 0 ZYGMNY+CMSY10 Type 1 Builtin yes yes no 70 0 XWVOFO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 77 0 EZIZZA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 85 0 UZLBPU+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 93 0 JRTYRQ+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 101 0 UHJWPU+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 105 0 OOIHJG+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 109 0 XWVOFO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 120 0 UZLBPU+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 128 0 EZIZZA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 136 0 JRTYRQ+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 144 0 UHJWPU+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 148 0 OOIHJG+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 152 0 XWVOFO+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 161 0 UZLBPU+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 169 0 EZIZZA+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 177 0 JRTYRQ+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 185 0 UHJWPU+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 189 0 OOIHJG+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 193 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 202 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-07-17 02:36:48 CEST RepresentationInformation: 296601.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-07-16 13:44:00 CEST Size: 1317538 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 332 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design and Variables Definition Destination: subsection.2.1 Item: Title: Outcome Measurements and Statistical Analysis Destination: subsection.2.2 Item: Title: Patient Positioning, Trocar Placement and Surgical Setting Destination: subsection.2.3 Item: Title: Surgical Technique and Postoperative Care Destination: subsection.2.4 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Simultaneous Bilateral Video Endoscopic Inguinal Lymphadenectomy for Penile Carcinoma: Surgical Setting, Feasibility, Safety, and Preliminary Oncological Outcomes Author: Josep M. Gaya, Giuseppe Basile, Pavel Gavrilov, Andrea Gallioli, Angelo Territo, Jorge Robalino, Pedro Hernandez, Raul Sanchez-Molina, Alejandra Bravo, Ferran Algaba, Jordi Huguet, Francesco Sanguedolce, Joan Palou, Antonio Rosales and Alberto Breda Subject: Introduction: Inguinal lymph node dissection (ILND) plays an important role for both staging and treatment purposes in patients diagnosed with penile carcinoma (PeCa). Video endoscopic inguinal lymphadenectomy (VEIL) has been introduced to reduce complications, and in those patients elected for bilateral ILND, a simultaneous bilateral VEIL (sB-VEIL) has also been proposed. This study aimed to investigate the feasibility, safety, and preliminary oncological outcomes of sB-VEIL compared to consecutive bilateral VEIL (cB-VEIL). Material and methods: Clinical N0-2 patients diagnosed with PeCa and treated with cB-VEIL and sB-VEIL between 2015 and 2023 at our institution were included. Modified ILND was performed in cN0 patients, while cN+ patients underwent a radical approach. Intra- and postoperative complications, operative time, time of drainage maintenance, length of hospital stay and readmission within 90 days, as well as lymph node yield, were compared between the two groups. Results: Overall, 30 patients were submitted to B-VEIL. Of these, 20 and 10 patients underwent cB-VEIL and sB-VEIL, respectively. Overall, 16 (80%) and 7 (70%) patients were submitted to radical ILND due to cN1-2 disease in the cB-VEIL and sB-VEIL groups, respectively. No statistically significant difference emerged in terms of median nodal yield (13.5 vs. 14, p = 0.7) and median positive LNs (p = 0.9). sD-VEIL was associated with a shorter operative time (170 vs. 240 min, p < 0.01). No statistically significant difference emerged in terms of intraoperative estimated blood loss, length of hospital stay, time to drainage tube removal, major complications, and hospital readmission in the cB-VEIL and sB-VEIL groups, respectively (all p > 0.05). Conclusions: Simultaneous bilateral VEIL is a feasible and safe technique in patients with PeCA, showing similar oncological results and shorter operative time compared to a consecutive bilateral approach. Patients with higher preoperative comorbidity burden or anesthesiological risk are those who may benefit the most from this technique. 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