Abstract：
To investigate the contemporary rates of 30-day complications after surgery for penile cancer and to discuss the currently used preventative and therapeutic practices aimed at mitigation of these postoperative adverse events.
A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed, and studies reporting on the contemporary rates, nature, or management of acute complications following primary penile surgery or inguinal lymph node dissection for penile cancer were abstracted. Medline (PubMed) and EMBASE libraries were used to retrieve the articles published between January 1984 and December 2021 (n = 170 articles). Ultimately, 38 articles were included. The primary outcome of interest was 30-day (acute) postoperative complications, stratified by those associated with treatment of the primary penile lesion and those with inguinal lymph node dissection. Risk of bias assessment was undertaken. Special attention was paid to studies reporting management strategies for these complications.
This comprehensive review revealed that the quality of existing studies reporting on complications is poor and the risk of bias is high. Within these studies, the rates of acute complications following primary penile surgery and inguinal lymph node dissection ranged between 0% and 29.4% and 6% and 90%, respectively. More than 50% of these complications were wound related. Over the past two decades, several studies have reported on improved surgical techniques and protocolized postsurgical care pathways. Although the newer techniques have been associated with improved outcomes, the absolute rates of complications have remained high even in the most contemporary series. Therefore, there is an urgent need for health care providers and stakeholders to reach consensus regarding preoperative workup and medical optimization goals, stage appropriate therapies, and postoperative care pathways, as has been done for other malignancies associated with high morbidity.
Penile cancer is a disease of the elderly, and surgical management of the primary lesion or the groins is associated with a high rate of complications. Most complications are wound related. Meticulous surgical technique and careful postoperative monitoring with early intervention are keys to mitigating surgery-related morbidity. However, equally important is dissemination and adoption of these principles by all health care workers universally.
A systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed, and studies reporting on the contemporary rates, nature, or management of acute complications following primary penile surgery or inguinal lymph node dissection for penile cancer were abstracted. Medline (PubMed) and EMBASE libraries were used to retrieve the articles published between January 1984 and December 2021 (n = 170 articles). Ultimately, 38 articles were included. The primary outcome of interest was 30-day (acute) postoperative complications, stratified by those associated with treatment of the primary penile lesion and those with inguinal lymph node dissection. Risk of bias assessment was undertaken. Special attention was paid to studies reporting management strategies for these complications.
This comprehensive review revealed that the quality of existing studies reporting on complications is poor and the risk of bias is high. Within these studies, the rates of acute complications following primary penile surgery and inguinal lymph node dissection ranged between 0% and 29.4% and 6% and 90%, respectively. More than 50% of these complications were wound related. Over the past two decades, several studies have reported on improved surgical techniques and protocolized postsurgical care pathways. Although the newer techniques have been associated with improved outcomes, the absolute rates of complications have remained high even in the most contemporary series. Therefore, there is an urgent need for health care providers and stakeholders to reach consensus regarding preoperative workup and medical optimization goals, stage appropriate therapies, and postoperative care pathways, as has been done for other malignancies associated with high morbidity.
Penile cancer is a disease of the elderly, and surgical management of the primary lesion or the groins is associated with a high rate of complications. Most complications are wound related. Meticulous surgical technique and careful postoperative monitoring with early intervention are keys to mitigating surgery-related morbidity. However, equally important is dissemination and adoption of these principles by all health care workers universally.
摘要：
调查阴茎癌手术后30天并发症的当代发生率，并讨论旨在减轻这些术后不良事件的当前使用的预防和治疗方法。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价，并研究报告当代利率，自然,对原发性阴茎手术或阴茎癌腹股沟淋巴结清扫术后急性并发症的处理进行了研究。Medline（PubMed）和EMBASE库用于检索1984年1月至2021年12月之间发表的文章（n=170篇文章）。最终,共38篇文章。感兴趣的主要结果是30天（急性）术后并发症，根据与原发性阴茎病变治疗相关的患者和腹股沟淋巴结清扫术进行分层。进行偏倚风险评估。特别注意报告这些并发症管理策略的研究。
这篇综合综述显示，现有研究报告并发症的质量很差，偏倚风险很高。在这些研究中,原发性阴茎手术和腹股沟淋巴结清扫术后的急性并发症发生率介于0%和29.4%以及6%和90%之间，分别。这些并发症中超过50％与伤口有关。在过去的二十年里，一些研究报道了改进的手术技术和原始的手术后护理途径。尽管较新的技术与改善的结果有关，即使在最现代的系列中，并发症的绝对发生率仍然很高。因此,迫切需要医疗保健提供者和利益相关者就术前检查和医疗优化目标达成共识，阶段适当的治疗，和术后护理途径，与其他与高发病率相关的恶性肿瘤一样。
阴茎癌是老年人的一种疾病,原发性病变或腹股沟的手术治疗与高并发症发生率相关。大多数并发症与伤口有关。精心的手术技术和早期干预的仔细的术后监测是减轻手术相关发病率的关键。然而,同样重要的是，所有卫生保健工作者普遍传播和采纳这些原则。
根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行系统评价，并研究报告当代利率，自然,对原发性阴茎手术或阴茎癌腹股沟淋巴结清扫术后急性并发症的处理进行了研究。Medline（PubMed）和EMBASE库用于检索1984年1月至2021年12月之间发表的文章（n=170篇文章）。最终,共38篇文章。感兴趣的主要结果是30天（急性）术后并发症，根据与原发性阴茎病变治疗相关的患者和腹股沟淋巴结清扫术进行分层。进行偏倚风险评估。特别注意报告这些并发症管理策略的研究。
这篇综合综述显示，现有研究报告并发症的质量很差，偏倚风险很高。在这些研究中,原发性阴茎手术和腹股沟淋巴结清扫术后的急性并发症发生率介于0%和29.4%以及6%和90%之间，分别。这些并发症中超过50％与伤口有关。在过去的二十年里，一些研究报道了改进的手术技术和原始的手术后护理途径。尽管较新的技术与改善的结果有关，即使在最现代的系列中，并发症的绝对发生率仍然很高。因此,迫切需要医疗保健提供者和利益相关者就术前检查和医疗优化目标达成共识，阶段适当的治疗，和术后护理途径，与其他与高发病率相关的恶性肿瘤一样。
阴茎癌是老年人的一种疾病,原发性病变或腹股沟的手术治疗与高并发症发生率相关。大多数并发症与伤口有关。精心的手术技术和早期干预的仔细的术后监测是减轻手术相关发病率的关键。然而,同样重要的是，所有卫生保健工作者普遍传播和采纳这些原则。
