Objective:

To present our experience in Endoscopic Inguinal Lymphadenectomy (IEL) in the management of penile cancer with risk factors for metastasis and clinically negative inguinal nodes (cN0); to evaluate the results obtained in the long term and with those described in the literature review, proposing "ideal objectives" for this minimally invasive technique.

Methodology:

Between 2012 and 2016, patients diagnosed with penile cancer who met the criteria for pathology greater than pT1G2 and cN0 inguinal nodes underwent IEL. We recorded pre-surgical, perioperative, pathological and follow-up data. We analyze results and discuss the evidence described in the literature review.

Results:

In 15 patients with a mean age of 59 years, 23 IELs were performed (08 bilateral and 07 unilateral). The average operative time was 126 minutes; all cases with bleeding less than 50cc. The mean number of lymph nodes dissected per inguinal region was 10.4; in 3 patients, 1 metastatic node was found. There were no Clavien-Dindo III or IV complications. During the mean follow-up period of 89 months (range 72-120), no patient had disease recurrence or progression.

Conclusions:

Long-term evaluation in this group of patients has shown to be an effective, safe and reproducible alternative with optimal results in cancer control, prompt functional recovery and minimum intra and postoperative complications. The various publications coincide in affirming that it has advantages compared to the conventional one, fulfilling these three “ideal objectives” that we qualify as a trifecta, like the concept used in other urooncological surgeries.

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