Do Surgical Techniques Used in Groin Lymphadenectomy for Vulval Cancer Affect Morbidity Rates?

Abstract

We recommend the use of subcuticular suture for wound closure. Patients who undergo lymphadenectomy with a node count per groin of more than 7 should be closely monitored for lymphedema and referred promptly to specialist services. The prolonged use of suction drainage may increase the risk of lymphedema.

Prognostic role of inguinal lymphadenectomy in vulvar squamous carcinoma: younger and older patients should be equally treated. A prospective study and literature review

“…Therefore, as concerns surgical complications following lymphadenectomy, we reported a complication rate of 33%, similar to those reported in the international literature [22][23][24][25][26][27][28][29][30][31][32][33][34][35]15]. Most common complications were wound breakdown and lymphedema.…”

Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer?

“…A recent prospective Dutch study by Pouwer and colleagues 11 of volume-controlled versus short-duration drainage following IFL in 141 vulvar cancer patients (251 groins) demonstrated that volume-controlled drainage (median duration, 13 days) was associated with significantly fewer complications compared with short drainage (median duration, 5 days). Our findings are not consistent with the studies by Walker et al 9 and Pouwer et al because we did not observe any difference in postoperative outcomes with duration of drain usage. This may reflect the limitations of retrospective studies with a small number of events and limited statistical power or differences between the study populations.…”

“…9 Walker and colleagues 9 conducted a retrospective analysis of 56 vulvar cancer patients who underwent groin dissection, 44 of whom had an inguinal suction drain, and did not report a reduction in surgical morbidity. However, Walker et al 9 did report that a short duration of drain use (1Y3 days) was associated with wound breakdown, and a long duration of use (Q7 days) was associated with higher rates of lymphedema.…”

“…8 Furthermore, surgical drainage of the groin at the site of dissection may be associated with an increased risk of lower-limb lymphedema when inguinal drains are used for more than 7 days and with wound dehiscence following short-term drain use (G4 days). 9 This study retrospectively evaluated a cohort of patients diagnosed as having early-stage vulvar cancer who received treatment at a statewide tertiary-level gynecologic cancer center. The objective was to determine whether draining the groin following IFL was associated with a reduction in postoperative morbidity compared with no drainage.…”

Information for Patients With or at Risk of Cancer-Related Lymphedema

“…Web sites that adhere to this principle will distinguish themselves while providing useful and relevant information to patients and the healthcare professionals that accompany them. Research shows that some healthcare professionals wish to identify patients at risk for developing lymphedema and refer them for preventive measures (Walker et al, 2011); the Internet could be a suitable support for them and their patients. When designing a Web site, an organization should cite the original sources used and regularly update or review the content.…”