Prevenir Complicações: Linfadenectomia Inguinal Modificada Vídeo-Assistida no Estadiamento do Tumor do Pénis
DOI:
https://doi.org/10.24915/aup.36.1-2.112Palavras-chave:
Complicações Pós-Operatórias, Excisão de Gânglio, Neoplasias Penianas, Procedimentos Cirúrgicos Robóticos, Procedimentos Cirúrgicos Urológicos MasculinosResumo
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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Referências
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2008;97:487-95.
7. Kumar V, Sethia KK. Prospective study comparing video-endoscopic radical inguinal lymph node dissection (VEILND) with open radical ILND (OILND) for penile cancer over an 8-year period. BJU Int. 2017;119:530-4. doi: 10.1111/bju.13660.
8. Jacobellis U. Modified radical inguinal lymphadenectomy for carcinoma of the penis: technique and results. J Urol. 2003;169:1349-52.
9. Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015;67:142-50. doi: 10.1016/j.eururo.2014.10.017
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(veil) for penile cancer: initial Denver health medical center and ABC school of medicine experience and surgical considerations. Int Braz J Urol. 2013;39:587-92.
11. Tobias-Machado M, Tavares A, Silva MN, Molina WR, Forseto PH, Juliano RV, et al. Can video endoscopic inguinal lymphadenectomy achieve a lower morbidity than open lymph node dissection in penile cancer patients? J Endourol. 2008;22:1687-91. doi: 10.1089/end.2007.0386.
12. Bevan-Thomas R, Slaton JW, Pettaway CA. Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the M.D. Anderson Cancer Center Experience. J Urol. 2002;167:1638-42.
13. Leijte JA, Kirrander P, Antonini N, Windahl T, Horenblas S. Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a two-centre analysis of 700 patients. Eur Urol. 2008;54:161-8. doi: 10.1016/j.eururo.2008.04.016.
14. Tobias-Machado M, Tavares A, Molina WR, Forseto PH, Juliano RV, Wroclawski ER. Video endoscopic inguinal lymphadenectomy (VEIL): minimally invasive resection of inguinal lymph nodes. Int Braz J Urol. 2006;32:316-21.
15. Yadav SS, Tomar V, Bhattar R, Jha AK, Priyadarshi S. Video Endoscopic Inguinal Lymphadenectomy vs Open Inguinal Lymphadenectomy for Carcinoma Penis: Expanding Role and Comparison of Outcomes. Urology.
2018;113:79-84. doi: 10.1016/j.urology.2017.11.007.
16. Chaudhari R, Khant SR, Patel D. Video endoscopic inguinal lymphadenectomy for radical management of inguinal nodes in patients with penile squamous cell carcinoma. Urol Ann. 2016;8:281-5. doi: 10.4103/0974-7796.184883.
17. Pahwa HS, Misra S, Kumar A, Kumar V, Agarwal A, Srivastava R. Video Endoscopic Inguinal Lymphadenectomy (VEIL)--a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma. World J Surg Oncol. 2013;11:42. doi: 10.1186/1477-7819-11-42.
18. Bouchot O, Rigaud J, Maillet F, Hetet JF, Karam G. Morbidity of in- guinal lymphadenectomy for invasive penile carcinoma. Eur Urol. 2004;45:761-5; discussion 5-6.
19. Nelson BA, Cookson MS, Smith JA, Chang SS. Complications of inguinal and pelvic lymphadenectomy for squamous cell carcinoma of the penis: a contemporary series. J Urol. 2004;172:494-7.
20. Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol. 2009;55:1075-88.
21. Catalona WJ. Re: Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J Urol. 1988;140:836.
22. Daseler EH, Anson BJ, Reimann AF. Radical excision of the inguinal and iliac lymph glands; a study based upon 450 anatomical dissections and upon supportive clinical observations. Surg Gynecol Obstet. 1948;87:679-94.
23. Sommariva A, Pasquali S, Rossi CR. Video endoscopic inguinal lymphadenectomy for lymph node metastasis from solid tumors. Eur J Surg Oncol. 2015;41:274-81. doi: 10.1016/j.ejso.2014.10.064.
24. Matin SF, Cormier JN, Ward JF, Pisters LL, Wood CG, Dinney CP, et al. Phase 1 prospective evaluation of the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy in patients with penile carcinoma. BJU Int. 2013;111:1068-74. doi: 10.1111/j.1464-410X.2012.11729.x.
25. Yuan P, Zhao C, Liu Z, Ou Z, He W, Cai Y, et al. Comparative study of video endoscopic inguinal lymphadenectomy through a hypogastric vs leg subcutaneous approach for penile cancer. J Endourol. 2018;32:66-72. doi: 10.1089/end.2017.0455.
26. Carlos AS, Romanelli P, Nishimoto R, Montoya LM, Juliano CA, Costa RM, et al. Expanded criteria for video endoscopic inguinal lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes. Int Braz J
Urol. 2013;39:893; discussion 4.
2. Christodoulidou M, Sahdev V, Houssein S, Muneer A. Epidemiology of penile cancer. Curr Probl Cancer. 2015;39:126-36.
3. Cindolo L, Spiess PE, Bada M, Chipollini JJ, Nyirády P, Chiodini P, et al. Adherence to EAU guidelines on penile cancer translates into better outcomes: a multicenter international study. World J Urol. 2018 (in press). doi: 10.1007/s00345-018-2549-3.
4. Hughes BE, Leijte JA, Kroon BK, Shabbir MA, Swallow TW, Heenan SD, et al. Lymph node metastasis in intermediate-risk penile squamous cell cancer: a two-centre experience. Eur Urol. 2010;57:688-92.
5. Graafland NM, Lam W, Leijte JA, Yap T, Gallee MP, Corbishley C, et al. Prognostic factors for occult inguinal lymph node involvement in penile carcinoma and assessment of the high-risk EAU subgroup: a two-institution
analysis of 342 clinically node-negative patients. Eur Urol. 2010;58:742-7.
6. Ornellas AA, Kinchin EW, Nóbrega BL, Wisnescky A, Koifman N, Quirino R. Surgical treatment of invasive squamous cell carcinoma of the penis: Brazilian National Cancer Institute long-term experience. J Surg Oncol.
2008;97:487-95.
7. Kumar V, Sethia KK. Prospective study comparing video-endoscopic radical inguinal lymph node dissection (VEILND) with open radical ILND (OILND) for penile cancer over an 8-year period. BJU Int. 2017;119:530-4. doi: 10.1111/bju.13660.
8. Jacobellis U. Modified radical inguinal lymphadenectomy for carcinoma of the penis: technique and results. J Urol. 2003;169:1349-52.
9. Hakenberg OW, Compérat EM, Minhas S, Necchi A, Protzel C, Watkin N. EAU guidelines on penile cancer: 2014 update. Eur Urol. 2015;67:142-50. doi: 10.1016/j.eururo.2014.10.017
10. Pompeo A, Tobias-Machado M, Molina WR, Lucio J, Sehrt D, Pompeo AC, et al. Extending boundaries in minimally invasive procedures with simultaneous bilateral video endoscopic inguinal lymphadenectomy
(veil) for penile cancer: initial Denver health medical center and ABC school of medicine experience and surgical considerations. Int Braz J Urol. 2013;39:587-92.
11. Tobias-Machado M, Tavares A, Silva MN, Molina WR, Forseto PH, Juliano RV, et al. Can video endoscopic inguinal lymphadenectomy achieve a lower morbidity than open lymph node dissection in penile cancer patients? J Endourol. 2008;22:1687-91. doi: 10.1089/end.2007.0386.
12. Bevan-Thomas R, Slaton JW, Pettaway CA. Contemporary morbidity from lymphadenectomy for penile squamous cell carcinoma: the M.D. Anderson Cancer Center Experience. J Urol. 2002;167:1638-42.
13. Leijte JA, Kirrander P, Antonini N, Windahl T, Horenblas S. Recurrence patterns of squamous cell carcinoma of the penis: recommendations for follow-up based on a two-centre analysis of 700 patients. Eur Urol. 2008;54:161-8. doi: 10.1016/j.eururo.2008.04.016.
14. Tobias-Machado M, Tavares A, Molina WR, Forseto PH, Juliano RV, Wroclawski ER. Video endoscopic inguinal lymphadenectomy (VEIL): minimally invasive resection of inguinal lymph nodes. Int Braz J Urol. 2006;32:316-21.
15. Yadav SS, Tomar V, Bhattar R, Jha AK, Priyadarshi S. Video Endoscopic Inguinal Lymphadenectomy vs Open Inguinal Lymphadenectomy for Carcinoma Penis: Expanding Role and Comparison of Outcomes. Urology.
2018;113:79-84. doi: 10.1016/j.urology.2017.11.007.
16. Chaudhari R, Khant SR, Patel D. Video endoscopic inguinal lymphadenectomy for radical management of inguinal nodes in patients with penile squamous cell carcinoma. Urol Ann. 2016;8:281-5. doi: 10.4103/0974-7796.184883.
17. Pahwa HS, Misra S, Kumar A, Kumar V, Agarwal A, Srivastava R. Video Endoscopic Inguinal Lymphadenectomy (VEIL)--a prospective critical perioperative assessment of feasibility and morbidity with points of technique in penile carcinoma. World J Surg Oncol. 2013;11:42. doi: 10.1186/1477-7819-11-42.
18. Bouchot O, Rigaud J, Maillet F, Hetet JF, Karam G. Morbidity of in- guinal lymphadenectomy for invasive penile carcinoma. Eur Urol. 2004;45:761-5; discussion 5-6.
19. Nelson BA, Cookson MS, Smith JA, Chang SS. Complications of inguinal and pelvic lymphadenectomy for squamous cell carcinoma of the penis: a contemporary series. J Urol. 2004;172:494-7.
20. Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol. 2009;55:1075-88.
21. Catalona WJ. Re: Modified inguinal lymphadenectomy for carcinoma of the penis with preservation of saphenous veins: technique and preliminary results. J Urol. 1988;140:836.
22. Daseler EH, Anson BJ, Reimann AF. Radical excision of the inguinal and iliac lymph glands; a study based upon 450 anatomical dissections and upon supportive clinical observations. Surg Gynecol Obstet. 1948;87:679-94.
23. Sommariva A, Pasquali S, Rossi CR. Video endoscopic inguinal lymphadenectomy for lymph node metastasis from solid tumors. Eur J Surg Oncol. 2015;41:274-81. doi: 10.1016/j.ejso.2014.10.064.
24. Matin SF, Cormier JN, Ward JF, Pisters LL, Wood CG, Dinney CP, et al. Phase 1 prospective evaluation of the oncological adequacy of robotic assisted video-endoscopic inguinal lymphadenectomy in patients with penile carcinoma. BJU Int. 2013;111:1068-74. doi: 10.1111/j.1464-410X.2012.11729.x.
25. Yuan P, Zhao C, Liu Z, Ou Z, He W, Cai Y, et al. Comparative study of video endoscopic inguinal lymphadenectomy through a hypogastric vs leg subcutaneous approach for penile cancer. J Endourol. 2018;32:66-72. doi: 10.1089/end.2017.0455.
26. Carlos AS, Romanelli P, Nishimoto R, Montoya LM, Juliano CA, Costa RM, et al. Expanded criteria for video endoscopic inguinal lymphadenectomy (VEIL) in penile cancer: palpable lymph nodes. Int Braz J
Urol. 2013;39:893; discussion 4.
