Endoscopic Inguinal Lymphadenectomy with a Novel Abdominal Approach to Vulvar Cancer: Description of Technique and Surgical Outcome

Video endoscopic inguinal lymphadenectomy for lymph node metastasis from solid tumors

“…28,29,33,37 Recurrence in regional LNs was a rare following VEIL, ranging between 0 and 6.6%, depending upon the length of follow-up. In one study, after a median follow-up of 55.3 months, a local recurrence rate of 6.6% was reported following VEIL, apparently not different from the open 29 20 33.0 15 0 Mean 120 (90e160) vs 92 (80e110) p ¼ 0.0002 Sotelo et al 30 14 87.5 15 0 60 (range 50e120) Delman et al 31 45 40.6 15e25 4.4 165 (range 75e245) Xu et al 32 17 0 10e15 0 94 (range 70e150) Schwentner et al 33 28 43.0 2e5 0 Mean 136.3 (range 87e186) vs 101,7 (range 38e195) p < 0.001 Sudhir et al 37 39 43.6 5e16 0 n.r. Zhou et al 34 11 36.4 n.r.…”

“…31 An increased end tidal CO 2 level was reported in a further 4 cases, 31,34,35 and successfully managed with proper anesthesiology technique or by intermittently decompressing the operative field. Intraoperative bleeding was minimal when specifically addressed 32,35 and not significantly different from the traditional procedure in one comparative study (30 cc versus 25 cc, p ¼ 0.007). 35 …”

“…29,33,37 Only one study reported data on the occurrence of post-operative lymphedema, which was detected in the 11% of cases. Hospital stay and drainage duration were extremely heterogenous, ranging from 1 to 11 days 28,29,32,34e36 and 5e28 days, 31,32,35,36 respectively. Strikingly, in two studies hospital stay after VEIL was significantly lower compared to open IL.…”

A Comparative Study of Video Endoscopic Inguinal Lymphadenectomy and Conventional Open Inguinal Lymphadenectomy for Treating Vulvar Cancer

“…15 It is recommended that both inguinal and femoral nodes are removed, because inguinal node dissection alone is associated with a higher incidence of groin recurrence. 18 The femoral nodes are situated medial to the femoral vein within the fossa ovalis.…”

“…10 One alternative is sentinel lymph node biopsy, 11Y13 which can reduce the incidence of postoperative complications; however, for vulvar cancer patients, this procedure is only recommended for single focal tumors measuring less than 4 cm and without clinical suspicion of inguinal lymph node metastasis. 11,13,14 Xu et al 15 was the first to report using VEIL to treat vulvar cancer via a hypogastric subcutaneous approach. Some reports 16,17 have suggested that surgeons using VEIL can resect comparable numbers of lymph nodes to those using COIL and that VEIL carries a lower morbidity of postoperative complications than COIL.…”