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Efficacy and Safety of Lateral Approach-Video Endoscopic Inguinal Lymphadenectomy (L-VEIL) over Open Inguinal Block Dissection: a Retrospective Study

  • Sandeep P. NayakEmail author
  • Harshwardhan Pokharkar
  • Jaiprakash Gurawalia
  • Kapil Dev
  • Srinivas Chanduri
  • M. Vijayakumar
Original Article

Abstract

This retrospective study compared the immediate post-operative short-term outcomes of Lateral Approach-Video Endoscopic Inguinal Lymphadenectomy (L-VEIL) and open surgery approach in patients with TNM stage N0 and N1 tumors. Inguinal lymphadenectomies performed for various TNM stage N0 and N1 cancers between January 2011 and December 2015 at a single center were analyzed by collecting data from operation theater records and case files. Mean blood loss, operative time, drain output, nodal yield, nodal positivity, and complications were analyzed as post-procedural outcomes. Among the 116 surgeries performed, 92 were open surgery and 24 were L-VEIL. Compared with open surgery, L-VEIL led to significantly lower blood loss (64.8 mL vs. 23.3 mL; p = 0.002), mean nodal yield (11.04 vs. 8.38; p = 0.001), and mean hospital stay (3.08 vs. 8 days; p < 0.001). However, the operative time was similar for both the groups (94.5 vs. 68.1 min; p = 0.08). Complications that were significantly low in L-VEIL were flap necrosis [RR 1.29; 95% CI (1.03–1.72); p < 0.001], wound dehiscence [RR 1.25; 95% CI (1.19–1.51); p = 0.005), wound infection [RR 1.34; 95% CI (1.19–1.51); p = 0.003], readmission [RR 1.3; 95% CI (1.17–1.44); p = 0.005], and re-surgery [p = 0.014]. Occurrence of complications such as lymphocele [RR 1.25; 95% CI (0.33–4.78); p = 0.5], lymphorrhea [RR 1.27; 95% CI (1.15–1.40); p = 0.5], and pedal edema [p = 0.2] were similar for both the approaches. L-VEIL was effective and safe compared with open inguinal block dissection in treatment of various TNM stage N0 and N1 urogenital and skin cancers.

Keywords

Lateral approach-video endoscopic inguinal lymphadenectomy (L-VEIL) Inguinal block dissection Vulvar cancer Penile cancer Melanoma 

Notes

Acknowledgments

The authors declare that they have no conflict of interest.

Author Contributions

Study conceptualization and design: NSP, PH, GJ; data acquisition and analysis: NSP, PH, GJ, DK, CS, VM; manuscript writing and reviewing: NSP, PH, GJ; guarantor: NSP, PH, GJ, DK, CS, VM

Supplementary material

13193_2019_951_Fig3_ESM.png (82 kb)
Figure S1

Strobe flow chart (PNG 82 kb)

13193_2019_951_MOESM1_ESM.tif (147 kb)
High Resolution Image (TIF 146 kb)
13193_2019_951_MOESM2_ESM.docx (14 kb)
ESM 2 (DOCX 14 kb)

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Copyright information

© Indian Association of Surgical Oncology 2019

Authors and Affiliations

  • Sandeep P. Nayak
    • 1
    Email author
  • Harshwardhan Pokharkar
    • 2
  • Jaiprakash Gurawalia
    • 2
  • Kapil Dev
    • 2
  • Srinivas Chanduri
    • 2
  • M. Vijayakumar
    • 3
  1. 1.Department of Surgical OncologyFortis Hospital and MACS ClinicBangaloreIndia
  2. 2.Department of Surgical OncologyKidwai Cancer InstituteBangaloreIndia
  3. 3.Vice ChancellorYenepoya UniversityMangaloreIndia

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