Expanded criteria for Video Endoscopic Inguinal Lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes

Carlos, Alexandre Stievano; Romanelli, Pedro; Nishimoto, Ricardo Hissashi; Montoya, Luis; Juliano, Cesar Augusto Braz; Costa, Renato M. Mariano da; Pompeo, Antônio Carlos Lima; Tobias-Machado, Marcos

doi:10.1590/s1677-5538.ibju.2013.06.17

Cited by 11 publications

(15 citation statements)

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“…We believe that the training model allowed standardization and optimized surgical time. This data is similar to other evidences in literature [14,18,25]. There was no significant difference in average operative bleeding among them.…”

Section: Discussionsupporting

confidence: 91%

“…The advantages are fast recovery with preliminary good results [14,17,24]. The refinement of this technique extending indications to patients with palpable lymph nodes was also described with good results [25]. In the last few years, innovations have been proposed to improve VEIL surgery and outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…Indication for VEIL was made based on pathological criteria. Patients with palpable lymph nodes were excluded from the study because only one series reporting data and surgery seems to be challenging [25].…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Tobias¹,

Lima²,

Aurus³

et al. 2017

Adv Laparoscopy

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Purpose: Video Endoscopic Inguinal Lymphadenectomy (VEIL) is feasible and safe in selected patient with groin metastases. Simultaneous bilateral performance seems to improve morbidity, however it still requires standardization. This article aims to describe a standardized and planned training model for VEIL. Materials and methods: This model comprises a standardized training as follows: 1) Oral and video presentation; 2) Two groins operated by the teacher with camera manipulated by trainees; 3) Simultaneous VEIL performed by trainees. Three medical centers tested this model between January and December 2014. Perioperative, functional and oncological data are evaluated. Statistical analysis was done by using arithmetic average and Student T-test. Data were compared among expert, trainees and trained surgeons. Results: Ten groins were operated by trainees and twenty by the same trained surgeons. Demographic characteristics are in accordance with most of the reported studies. Surgical performance and oncological results of trainees and trained surgeons didn't differ significantly from the expert surgeon. Conclusions: Despite the limited number of patients, the proposed model is effective as an option for training in large scale. Potential advantages include feasibility and optimization of operative time.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Tobias¹,

Lima²,

Aurus³

et al. 2017

Adv Laparoscopy

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“…Alguns autores, influenciados pelos bons resultados da LIMVA, têm apresentado resultados de linfadenectomia vídeo-assistidas em doentes com gânglios palpáveis, referindo segurança oncológica da técnica. 16,26 No entanto, os dados existentes são ainda insuficientes para uma recomendação nesse sentido.…”

Section: Discussionunclassified

Prevenir Complicações: Linfadenectomia Inguinal Modificada Vídeo-Assistida no Estadiamento do Tumor do Pénis

Pereira-Lourenço¹,

Vieira-Brito²,

Godinho³

et al. 2019

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A linfadenectomia inguinal modificada permite um estadiamento correto na maioria dos casos de carcinoma do pénis sem gânglios inguinais palpáveis. Atualmente, é possível reproduzir a técnica cirúrgica clássica por via vídeo-assistida, com resultados oncológicos semelhantes e menor taxa de complicações. O artigo reporta um caso de tumor do pénis, sujeito a penectomia total (pT3NxMx), sem gânglios inguinais palpáveis, onde se realizou uma linfadenectomia inguinal modificada vídeo-assistida (LIMVA) bilateral, sendo descrita a técnica cirúrgica da LIMVA direita. Neste artigo são descritos todos os passos da técnica cirúrgica (posicionamento do doente, disseção romba profundamente à faixa de Scarpa, identificação dos limites anatómicos da disseção, identificação dos vasos femorais, identificação da veia safena até a fossa ovalis, excisão dos gânglios e encerramento). A grande vantagem da LIMVA é a diminuição de complicações pós-operatórias, nomeadamente a baixa taxa de deiscência da ferida operatória e de edema dos membros inferiores.

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“…A new procedure, known as video endoscopic inguinal lymphadenectomy (VEIL) [14], has recently been proposed as a safe option to reduce postoperative morbidity in classical lymphadenectomy, both palpable and non-palpable nodes. A few centres around the world have performed this technique and several prospective multicenter studies will be needed to assess its long-term oncological outcome despite its initial success.…”

Section: Discussionmentioning

confidence: 99%

Inguinal Lymphadenectomy Assessment Associated with Penile Carcinoma Undergone New Strategies for Nodal Staging

Gómez¹,

Cuesta²,

Bretones³

et al. 2014

CRCM

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Penile carcinoma is an uncommon urological tumour and provides an opportunity for curation on early stage of the disease. Nodal metastases are one of the most important prognostic factors for survival although detection of inguinal adenopathies could be related with an inflammatory or infectious etiology. A suspicion of bilateral metastasic nodal involvement should be taken with caution. Radical inguinal lymphadenectomy has been associated to a great deal of complications. Several anatomical studies have reported the true lymphatic drainage pathways in order to reduce the area of groin dissection. Nonetheless, a prophylactic modified inguinal lymphadenectomy should not be a systematic surgical procedure in all patients due to morbidity and questioned usefulness when there are not nodal metastasis. Classical imaging studies have a limited contribution to the diagnosis of lymph node metastasis. Nowadays, lymph node involvement may be diagnosed both minimally invasive and noninvasive techniques, such as dynamic sentinel lymph node biopsy in intermediate and high risk patients with nonpalpable lymph nodes, and fine needle aspiration biopsy in cases with palpable nodes. Their high effectiveness has facilitated the radical pelvic or inguinal lymphadenectomy that is only performed when there is histological confirmation of nodal involvement. A new video endoscopic technique has been developed at present to reduce postoperative complications although prospective studies are needed to assess outcomes. The appearance of adenopathies after surgical treatment of the primary tumour could be supported at the same guidelines. An inguinal lymphadenectomy should be carried out in selected patients to support a benefit on early stages with an extended survival.

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Expanded criteria for Video Endoscopic Inguinal Lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes

Cited by 11 publications

References 0 publications

Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Simultaneous Bilateral Surgery as a Model for Learning Video Endoscopic Inguinal Lymphadenectomy (VEIL)

Prevenir Complicações: Linfadenectomia Inguinal Modificada Vídeo-Assistida no Estadiamento do Tumor do Pénis

Inguinal Lymphadenectomy Assessment Associated with Penile Carcinoma Undergone New Strategies for Nodal Staging

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