title: Radical open inguinal lymphadenectomy for penile carcinoma: surgical technique, early complications and late outcomes.
abstract: OBJECTIVE
  We reviewed our recent experience with inguinal lymph node dissection in patients with penile cancer to assess the incidence and magnitude of complications caused by this procedure.
  
  
  METHODS
  Radical bilateral inguinal lymphadenectomy was performed in 170 patients (340 procedures). Prophylactic and therapeutic radical inguinal lymphadenectomy was done in 67 (39.4%) and 103 patients (60.6%), respectively. Operative time and length of hospital stay were examined. Complications were divided into minor and major, and early (30 days or less after surgery) and late (greater than 30 days), and analyzed.
  
  
  RESULTS
  A total of 35 complications (10.3%) were observed, of which 25 (71.4%) were minor and 10 (28.6%) were major. We noted lymphedema in 14 patients (4.1%), seroma in 4 (1.2%), scrotal edema in 3 (0.9%), skin edge necrosis in 3 (0.9%), lymphocele in 3 (0.9%), wound infection in 2 (0.6%), flap necrosis in 2 (0.6%), wound abscess in 2 (0.6%) and deep venous thrombosis in 2 (0.6%). There was no significant difference in complication rates between patients treated with prophylactic vs therapeutic dissection. Mean hospital stay was 6.4 days (range 4 to 27). Average operative time for radical unilateral inguinal lymphadenectomy was 94 minutes.
  
  
  CONCLUSIONS
  Our contemporary series includes a lower incidence of complications, such as wound infection, skin flap necrosis, lymphocele and lymphedema. To our knowledge this series represents the lowest incidence rate of complications described in the international literature.
authors.affiliation: Departments of Urology, Mário Kröeff Hospital and Souza Aguiar Municipal Hospital (LK, DH), Rio de Janeiro, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: Koifman
authors.forename: Daniel
authors.initials: D
authors.lastname: Hampl
authors.forename: Nelson
authors.initials: N
authors.lastname: Koifman
authors.forename: Antonio José
authors.initials: AJ
authors.lastname: Vides
authors.forename: Antonio Augusto
authors.initials: AA
authors.lastname: Ornellas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D015994:Incidence; D007264:Inguinal Canal; D008197:Lymph Node Excision / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: DVT; RIL; carcinoma; deep vein thrombosis; lymph node dissection; outcome assessment (health care); penis; postoperative complications; radical inguinal lymphadenectomy