Early Wound Complications After Inguinal Lymphadenectomy in Penile Cancer: A Historical Cohort Study and Risk-factor Analysis

Sarcopenia as a predictor of complications in penile cancer patients undergoing inguinal lymph node dissection

“…In a recent analysis of 163 patients who underwent ILND, Stuiver et al [22] reported a 58 % overall complication rate and a 10 % severe (Clavien ≥ III) complication rate with a 43 % incidence of wound infection, 24 % incidence of seroma formation, and 16 % incidence of skin-flap problems. BMI (OR 1.76, p = 0.03), sartorius muscle transposition (OR 2.12, p = 0.06), and bilateral dissection (OR 2.17, p = 0.06) were the factors most strongly associated with the occurrence of Clavien ≥ II wound complications.…”

Protection of femoral vessels and vascular grafts after inguinal lymphadenectomy or femoral bypass by using prophylactic routine sartorius muscle flap shield coverage

“…13 Some authors may prefer using the rectus femoris muscle flap if the dead space is large for its bigger bulk. 1,12,17,28 Chatterjee A et al reported that the rectus femoris muscle flap is more cost effective when used to treat the infected vascular groin graft wound.…”

“…These may be attributed mainly to the potentially contaminated groin area, division of the blood supply to the skin flaps, interruption of collateral lymphatics and the presence of a large dead space in the femoral triangle giving chance for serous or lymphatic collection. 7,[12][13][14][15] In the previous era, the treatment of groin infected grafts was total excision of the graft with massive debridement and extra-anatomical bypass. Limb loss and mortality rates were reported as 10% -79% and 9% -58%, respectively.…”

Current surgical management of penile cancer

“…50 Radical ILND is associated with significant postoperative morbidity including wound infection, wound dehiscence, skin necrosis, hematoma, lymphocele or seroma formation, and chronic scrotal or lower limb lymphedema. 51 Prophylactic intravenous antibiotics, meticulous closure of lymphatic vessels with ligation or clips, and early use of compression stockings, sequential pneumatic compression devices, and inguinal pressure dressings are necessary to minimize complications after surgery. 52 Anticoagulation with low-molecular-weight heparin may also decrease the risk of deep vein thrombosis and pulmonary embolism postoperatively.…”