Clinical Application of Endoscopic Inguinal Lymph Node Resection after Lipolysis and Liposuction for Vulvar Cancer

Abstract

Aim: To examine lymph nodes obtained after lipolysis and liposuction of subcutaneous fat of the inguinal region of female vulvar cancer patients to explore the feasibility of clinical application. Methods: The field of operation was on the basis of the range of the conventional resection of inguinal lymph nodes. We injected lipolysis liquid fanwise, started liposuction after 15-20 minutes; then the subcutaneous fatty tissue was sucked out clearly by suction tube. We selected the first puncture holes located on 2-3 cm part below anterior superior spine, the others respectively being located 3cm and 6cm below the first for puncturing into the skin, imbedding a trocar to intorduce CO 2 gas and the specular body, and excise the lymph nodes by ultrasonic scalpel. The surgical field chamber was set with negative pressure drainage and was pressured with a soft saline bag after surgery. Results: A lacuna emerged from subcutaneous of the inguinal region after lipolysis and liposuction, with a wide fascia easily exposed at the bottom where lymph nodes could be readily excised. The number of lymph nodes of ten patients excised within the inguinal region on each side was 4-18. The excised average number of lymph nodes was 11 when we had mature technology. Conclusion: Most of adipose tissue was removed after lipolysis and liposuction of subcutaneous tissue of inguinal region, so that the included lymph nodes were exposed and easy to excise by endoscope. This surgery avoided the large incision of regular surgery of inguinal region, the results indicating that this approach is feasible and safe for used as an alternative technology.

Evidence Based Analysis of Cisplatin for Treating Patients with Cutaneous Squamous Cell Carcinoma

“…Skin cancer is an important research topic in China (Deng et al, 2013;Hao et al, 2013;Wang et al, 2013;Wu et al, 2013). CSCC with distant metastasis, while rare, is more common than metastatic basal cell cancer.…”

Video Endoscopic Inguinal Lymphadenectomy via 3-Incision Lateral Approach for Vulvar Cancers: Our Preliminary Outcome of 37 Cases

“…The puncture holes were internally sutured with Vicryl. The vulvectomy was conducted as described previously 11 and incisions were also sutured with multilayer Vicryl, whereas the skin mucous membrane incisal edges were internally sutured with Vicryl. After the surgery, the drainage tube was connected to the vacuum suction ball (once the drainage was less than 5 mL, the drainage tube was removed).…”

“…8,9 The VEIL-based treatment of penile cancer and vulvar cancer has been extensively reported. 3,10,11 In most cases, the endoscope and surgical instruments are placed into the inguinal region via the umbilicus and the lower abdomen downward, or via the midthigh upward, and then the massive fat tissues containing lymph nodes in the inguinal region are excised.…”

“…We tried the 3-incision lateral approach for the first time, and established the VEIL via this approach. 11 So far, 37 patients have received this surgery and been followed up. Here, we summarize the findings.…”

The Impact of Tumor and Lymph Node Characteristics on Disease Free Survival in Squamous Cell Vulvar Cancer.

“…Although new methods for lymph node dissection were introduced, the widely used surgical treatment includes tumor resection with free margins and inguinofemoral lymph node dissection. [1][2][3] Since two decades, involvement of groin lymph nodes (LNs) has been reported as the most important prognostic factor for survival. 4 The age, tumor size, tumor location, stage, depth of invasion, the LN status and free margins were suggested as the possible predictive factors of recurrence.…”