Complications of inguinal and pelvic lymphadenectomy for squamous cell carcinoma of the penis: a contemporary series.
OBJECTIVE
We examined complications in a contemporary population of patients with penile cancer undergoing inguinal lymphadenectomy with or without pelvic lymphadenectomy.


METHODS
The records of all patients treated for squamous cell carcinoma of the penis from January 1992 to May 2003 were reviewed. Complications and length of stay were examined. Complications were divided into early (30 days or less after surgery) and late (greater than 30 days).


RESULTS
A total of 41 men were diagnosed with squamous cell carcinoma of the penis, of whom 22 underwent a total of 40 inguinal lymphadenectomies (ILs). Of the patients 13 underwent unilateral IL, 9 underwent simultaneous bilateral ILs and 10 underwent pelvic lymphadenectomy. Mean followup was 34.2 months (range 9.2 to 69.3). Early complications were lymphedema in 4 of 40 cases (10%), minor wound infection in 3 (7.5%) and minor wound separation in 3 (7.5%). Additionally, 5 of 40 patients (12.5%) had lymphoceles, which spontaneously resolved. Late complications were lymphedema in 2 of 40 patients (5%), flap necrosis in 1 (2.5%) and lymphocele in 1 (2.5%), requiring percutaneous drainage. There was no significant difference in the complication rates in patients with unilateral dissection compared to bilateral or pelvic lymph node dissection. Median length of stay was 2 days (range 1 to 9). There was no significant difference in hospital stay for unilateral dissection compared to bilateral or pelvic lymph node dissection.


CONCLUSIONS
These data demonstrate the relative safety of a contemporary lymphadenectomy. We believe that these results lend support to early lymphadenectomy, including simultaneous bilateral dissections, when clinically indicated. Furthermore, these results demonstrate the benefits of a standard postoperative pathway using compression stockings, sequential compression devices and early ambulation with restricted anticoagulant use.
Nelson
Bradford A
BA
Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37232, USA.
Cookson
Michael S
MS
Smith
Joseph A
JA
Chang
Sam S
SS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004434:Early Ambulation; D006801:Humans; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000601:surgery*