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Surgical Outcomes of Glansectomy and Split Thickness Skin Graft Reconstruction for Localized Penile Cancer

  • Marco Falcone
    Correspondence
    Address correspondence to: Marco Falcone, MD PhD, Department of Neurourology – “Città della Salute e della Scienza”, Department of Urology – “Città della Salute e della Scienza”, Department of Surgical Sciences, University of Turin, Turin, Italy.
    Affiliations
    A.O.U. Città della Salute e della Scienza di Torino, Department of Neurourology, Italy

    A.O.U. Città della Salute e della Scienza di Torino – University of Turin, Department of Urology, Turin, Italy
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  • Marco Oderda
    Affiliations
    A.O.U. Città della Salute e della Scienza di Torino – University of Turin, Department of Urology, Turin, Italy
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  • Giorgio Calleris
    Affiliations
    A.O.U. Città della Salute e della Scienza di Torino – University of Turin, Department of Urology, Turin, Italy
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  • Federica Peretti
    Affiliations
    A.O.U. Città della Salute e della Scienza di Torino – University of Turin, Department of Urology, Turin, Italy
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  • Paolo Gontero
    Affiliations
    A.O.U. Città della Salute e della Scienza di Torino, Department of Neurourology, Italy

    A.O.U. Città della Salute e della Scienza di Torino – University of Turin, Department of Urology, Turin, Italy
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      Introduction

      The management of localized penile cancer is based on organ-sparing approaches. Our aim is to report surgical outcomes of glansectomy (GS) and split thickness skin graft (STSG) reconstruction in a consecutive series of penile cancers.

      Patients and Methods

      Patients with a localized penile cancer underwent GS and STSG reconstruction in tertiary referral center. Data were extrapolated from a single center prospective database starting from May 2013 to August 2019. Two different techniques are presented in the video abstract: - a standard GS with dissection over the Bucks’ fascia. - a salvage GS with dissection under Bucks’ fascia.

      Results

      A total of 34 patients were enrolled. 30 patients underwent a standard GS, whether a salvage GS was performed in the remainders. The apex of corpora cavernosa was transected in 5 cases due to suspicious of local invasion. Median follow-up was 12 (12-41) months. Operative time was 150 (105-180) minutes. Hospital stay was 2 (1-3) days. A modified TODGA compressive dressing and a catheter were applied and left in place for 5 days. After that a saline washing was used for 2 weeks. The incidence of intraoperative complications was minimal (2.9%). Positive surgical margins were detected in 2.9% of cases, requiring a salvage surgery. The incidence of postoperative complications was 29.4%: 11.7% were classified as Grade 1, 8.8% as Grade 2 and 8.8% as Grade 3a according to Clavien-Dindo classification. 1-year recurrence free-survival (RFS) was 88.2%. 1-y cancer-specific (CSS) and overall survival (OS) resulted 91.2% in both cases. Limitations of the study were the retrospective and single centre nature of the study, the lack of comparative group, the limited number of cases and of follow-up.

      Conclusions

      GS and STSG reconstruction represents a safe procedure burden by a low incidence of postoperative complications providing a satisfactory cancer control, with a minimal risk of local recurrence.
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