[Invasiveness of lymphadenectomy in penis cancer]

Obligatory statements on the value of lymphadenectomy in penile cancer are difficult because of the rarity of the tumor. Reservations against a general application of inguinal or ileoinguinal lymphadenectomy in penile cancer are made because of severe complications as long-term lymph fistulas, skin necroses, scar contractures, vascular injuries and restrictions of the leg motility. Measures to reduce these complications are of great value. By a special intraoperative and postoperative regimen in our own patients severe complications could be avoided. With the use of absorbable ligation material the development of long-term fistulas is prevented and by a redon drainage of 15 days the development of wound ruptures and scar contractures are avoided. Although in all cases investigated by lymphangiography a lymph flow obstruction was verified only discrete lymph edemas of the lower extremities were found clinically. Thereby an opening of preformed lympho-venous anastomoses due to outflow obstruction and simultaneous tissue compression should be assumed.