Sparing of saphenous vein during inguinal lymphadenectomy for vulval malignancies
Section snippets
Background
Inguinal lymphadenectomy plays an important role in the cure of patients with inguinal metastasis from vulval cancer or prophylactic inguinal lymphadenectomy. Unfortunately, this treatment is often associated with multiple postoperative complications usually classified into minor-wound infection, seroma formation requiring drainage, skin necrosis, low extremity pain, and sense abnormity, and major-deep venous thrombosis, persistent seroma formation, flap necrosis requiring skin graft, low
Clinical materials
There were 89 patients with vulval malignancies enrolled in our hospital from Jan of 1989 to Dec of 2005, and 22 of them were referred from outside institutions for their recurrence or further surgery. 64 of the above 89 patients were subjected to radical vulvectomy combined with bilateral inguinal lymphadenectomy using separate groin incisions. These 64 patients were from 36 to 75 years old with the median age being 59, and 34 of them were more than 60 years old. The distribution of FIGO
Operative time duration and intraoperative blood loss
The median operative time for bilateral inguinal lymphadenectomy was 155 min (130–170 min) in the sparing group, similar to that in the excision group, 140 min (120–170 min) (P > 0.05). Besides, the estimated median blood loss was 295 ml (100–50 ml) in the sparing group, also similar to that in the excision group, 270 ml (150–90 ml) (P > 0.05), and no statistical difference was observed.
Wound healing
Primary wound healing was noted in 17 (27.4%) groin incisions in the sparing group vs. 11 (16.7%) in the excision
Discussion
The primary therapeutic approach to cure vulval malignancies is surgery, whose operative procedure for individual case depends closely on the size and location of the lesion, stage of the disease, general condition and age of the patient, as well as the condition of the surrounding tissue and possible continuance of sexual life. The routinely operative modality was radical vulvectomy with bilateral dissection of the groin nodes recommended by Tanssig and Way [2], [3], and the surgical treatment
Acknowledgments
We would like to thank Dr. Beihua Kong from Qilu Hospital of Shandong Medical University and J. Howard from Shandong University of China for their critical reading of the manuscript.
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2017, Gynecologic Oncology ReportsPrognostic role of inguinal lymphadenectomy in vulvar squamous carcinoma: Younger and older patients should be equally treated. A prospective study and literature review
2015, Gynecologic OncologyCitation Excerpt :In the present study the lymphadenectomy was carried out in very elderly patients also, showing that in these patients it seems to be feasible with no higher complication rates than in younger patients. Therefore, as concerns surgical complications following lymphadenectomy, we reported a complication rate of 33%, similar to those reported in the international literature [22–35,15]. Most common complications were wound breakdown and lymphedema.