Risk factors for postoperative surgical complications after inguinal lymph node dissection in penile cancer patients

Wound related and lymphatic reflow-related complications are commonly seen in penile cancer patients after inguinal lymph node dissection (ILND). However, the risk factors for them remain unclear. The objective of this study is to identify surgical-related risk factors for complications after ILND in penile squamous cell carcinoma (PSCC) patients. In this study, 192 PSCC patients aged 23-88 were enrolled between October 2008 and October 2023. Univariate analysis and logistic regression were performed to identify risk factors. Receiver operating characteristic (ROC) curves were used to analyze the relationship between certain risk factors and postoperative complications and find cut-off points for certain risk factors. Postoperative complications were observed in 87.5% of patients, with lymphatic fistula being the most common (50.0%) and wound dehiscence the least common (1.1%). Different factors were associated with each complication. Additionally, we found that the retention time of the drainage tube correlates with both lymphocele and wound infection, emphasizing the importance of optimizing drainage tube management to reduce lymphatic and wound-related complications. In conclusion, this study identified specific risk factors for complications after ILND in PSCC patients, particularly the shorter and longer retention times of the drainage tube for lymphocele and wound infection as determined by our multivariate analysis, and proposed new strategies to not only reduce the occurrence of these complications but also accelerate the postoperative healing process.