title: Fascia lata preservation during inguinal lymphadenectomy for penile cancer: rationale and outcome.
abstract: OBJECTIVE
  To investigate local groin recurrence and morbidity associated with fascia lata preservation during inguinal lymphadenectomy (LAD) for penile carcinoma.
  
  
  METHODS
  Between January 2002 and December 2011, 201 inguinal dissections with preservation of the fascia lata were performed in 104 patients with clinical disease staged at ≤N2. The dissection boundaries were the same as those for radical inguinal LAD. All superficial inguinal nodes were removed en bloc. The cribriform fascia near the femoral canal was divided, and the deep inguinal lymph nodes were dissected. The fascia lata was completely preserved and sutured to the subcutaneous tissue. Sartorius muscle transposition was eliminated. Survival and morbidity data were retrospectively analyzed, and survival probabilities were calculated.
  
  
  RESULTS
  The median operative time for unilateral inguinal LAD was 45 minutes (range, 40-60 minutes). Median follow-up was 36 months (range, 10-130 months). A mean number of 12.5 nodes were removed per groin. One patient (1%) had a recurrence outside the borders of the fascia lata after 7 months of follow-up. The 3-year disease-free survival rate was 92.1% (100% for pN0, 91.3% for pN1, 80% for pN2, and 33.3% for pN3 disease). A total of 59 complications (29.3%) occurred, including wound infection (2.5%), skin necrosis (5.5%), lymphedema (11.8%), seroma formation (1.5%), lymphocele (5%), paresthesia (3.5%), and deep venous thrombosis (0.5%).
  
  
  CONCLUSIONS
  Inguinal dissections with preservation of the fascia lata for penile carcinoma patients without extranodal extension is as effective as the classic dissection technique but decreases complications related to groin dissection.
authors.affiliation: Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Yao
authors.forename: Zi-jun
authors.initials: ZJ
authors.lastname: Zou
authors.forename: Zai-shang
authors.initials: ZS
authors.lastname: Li
authors.forename: Fang-jian
authors.initials: FJ
authors.lastname: Zhou
authors.forename: Zi-ke
authors.initials: ZK
authors.lastname: Qin
authors.forename: Zhuo-wei
authors.initials: ZW
authors.lastname: Liu
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Li
authors.forename: Hui
authors.initials: H
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary / Q000601:surgery*; D018572:Disease-Free Survival; D005206:Fascia Lata / Q000601:surgery*; D006801:Humans; D007264:Inguinal Canal; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008207:Lymphatic Metastasis; D008209:Lymphedema / Q000209:etiology; D008210:Lymphocele / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000209:etiology; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000009:adverse effects; D010292:Paresthesia / Q000209:etiology; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D012867:Skin / Q000473:pathology; D013530:Surgical Wound Infection / Q000209:etiology; D020246:Venous Thrombosis / Q000209:etiology; D055815:Young Adult