[V.A.C. (Vacuum Assisted Closure) therapy as a treatment option in complications following lymphadenectomy in patients with penile cancer].
BACKGROUND
Penile cancer is a rare tumor entity. Primary therapy consists of tumor excision (laser therapy, circumcision, partial or complete penectomy). Therapy of advanced or metastasized penile cancer is still challenging due to high morbidity with postoperative lymph edema, fistula, wound infection and resulting secondary wound healing.


METHODS
In this series we retrospectively investigated clinical and diagnostic data from 28 patients (1995-2005) with penile cancer regarding their follow-up, especially in respect to morbidity after lymphadenectomy and the resulting therapy. We evaluated the efficacy of V.A.C. therapy as an alternative in this setting regarding costs and duration of hospital stay.


RESULTS
11/28 pats. underwent lymphadenectomy (LA) because of tumor stage or suspicious lymph node status. Eight of those pats. developed complications, as there were: lymph edema, and/or secondary wound healing with fistula. 4/8 pats. were treated with V.A.C. therapy. In this group a significant advantage regarding cost and time of hospitalization was observed.


CONCLUSIONS
Despite higher primary introduction costs an early V.A.C. therapy in patients with secondary wound healing and lymph obstruction is advisable and resulted in a shortened hospitalization and reduced overall costs per patient.
Urologische Universitätsklinik, Universitätsklinikum Magdeburg A. ö. R., Deutschland. olrik.rau@medizin.uni-magdeburg.de
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Reiher
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Allhoff
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003646:Debridement; D005402:Fistula / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008197:Lymph Node Excision; D008206:Lymphatic Diseases / Q000601:surgery; D008207:Lymphatic Metastasis / Q000473:pathology; D008209:Lymphedema / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009779:Occlusive Dressings; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation; D013530:Surgical Wound Infection / Q000601:surgery; D016896:Treatment Outcome; D014618:Vacuum; D014945:Wound Healing / Q000502:physiology