Radical inguinal lymph node dissections (rILND) for penile cancer risk significant postoperative lymphocele and lymphedema. However, reducing the risk of lymphatic complications is limited by our understanding of lymphatic anatomy. Therefore, this study aims to elucidate the lymphatic anatomy within the current surgical borders of a rILND.
To visualize the position of the lymph nodes, tissue packets excised from the inguinal region of five fresh, male cadavers were imaged using microcomputed tomography (CT). To standardize the position, rotation and size between specimens, each lymph node packet was aligned using a Generalized Procrustes analysis.
There was a median of 13.5 lymph nodes (range=8-18) per packet, with the majority (99%) clustered within a 6cm radius of the saphenofemoral junction; a region 39%-41% smaller than current surgical borders. No difference existed between the number of nodes between sides, or distribution around the saphenofemoral junction.
This study provides the first 3D, in situ, standardized characterization of lymph node anatomy in the inguinal region using CT. By using knowledge of the normal lymphatic anatomy, this study can help inform the reduction in borders of rILND to limit disruption and ensure a complete lymphadenectomy.
Journal of surgical oncology. 2020 Sep 10 [Epub ahead of print]
Kait Marshall, Shiva M Nair, Katherine E Willmore, Tyler S Beveridge, Nicholas E Power
Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada., Department of Surgery, Urology Division, Schulich School of Medicine & Dentistry, Western University, London, Ontorio, Canada.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/32914446
Recommendation and review posted by G. Smith
