{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:09:27Z","timestamp":1792606167711,"version":"4.5.0"},"reference-count":40,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Long-term survival in penile cancer is dependent on the presence and extent of lymph node metastases. Historically, inguinal lymph node dissection (ILND) has been performed via an open approach (O-ILND). More recently, minimally invasive surgical alternatives (MIS-ILND) such as video-endoscopic and robot-assisted ILND have emerged. This review aims to compare the (1) perioperative outcomes, (2) complication rates, and (3) oncological efficacy between O-ILND and MIS-ILND. Methods: We conducted a PRISMA-compliant meta-analysis including studies comparing O-ILND versus MIS-ILND for penile cancer. Outcomes were pooled in random-effects meta-analyses. Results: Sixteen articles comprising 1054 patients were analysed. There was an observed trend towards longer operative time for the MIS-ILND approach (mean difference 28 min; 95% CI \u22122 to 58 min, p = 0.06), particularly with the robotic-assisted technique. Total LN yield (mean 12.3, mean difference 0.3, 95% CI \u22120.3 to 0.9, p = 0.13), and positive LN (RR 0.98, 95% CI 0.88\u20131.10, p = 0.75) were similar between groups. MIS-ILND significantly reduced complication rates for both minor (RR: 0.65, 95% CI 0.45\u20130.94, p = 0.02) and major complications (RR: 0.25, 95% CI 0.12\u20130.53, p = 0.002). Particularly, there was also lower wound infection rate with MIS-ILND (RR: 0.43, 95% CI 0.22\u20130.82, p = 0.02), corresponding to a shorter hospital stay of average 4 days (MD \u22124, 95% CI \u22126\u2013\u22122, p = 0.05). Rates of skin\/flap necrosis, lymphedema, lymphocele, and drainage time did not differ significantly. Local groin recurrence and overall survival did not differ between approaches. Conclusions: MIS-ILND is associated with fewer perioperative complications and shorter hospitalisation without compromising oncologic outcomes. These findings support its broader adoption, particularly in high-volume centres with appropriate surgical expertise.<\/jats:p>","DOI":"10.3390\/cancers17183035","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T13:03:02Z","timestamp":1758114182000},"page":"3035","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparing the Perioperative and Oncological Outcomes of Open Versus Minimally Invasive Inguinal Lymphadenectomy in Penile Cancer: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"given":"Yu Guang","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khi Yung","family":"Fong","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-8470","authenticated-orcid":false,"given":"Nathanael Kai-Jun","family":"Goh","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alvin YM","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kae Jack","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John SP","family":"Yuen","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Abern","sequence":"additional","affiliation":[{"name":"Department of Urology, Duke University School of Medicine, Durham, NC 27710, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3844-7567","authenticated-orcid":false,"given":"Kenneth","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, Singapore General Hospital, Singapore 169854, Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3109\/00365599.2012.677473","article-title":"Initial symptoms and delay in patients with penile carcinoma","volume":"46","author":"Skeppner","year":"2012","journal-title":"Scand. 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