Groin Dissection Practices among Gynecologic Oncologists Treating Early Vulvar Cancer

Management of patients with vulvar cancer: a perspective review according to tumour stage

“…For this procedure, it is not sufficient to concentrate on superficial inguinal lymphadenectomy as recurrences in deep femoral lymph nodes have been observed [DiSaia et al 1979;Levenback et al 1996;Micheletti et al 1990]. Therefore, groin surgery has to comprise inguinofemoral lymphadenectomy.…”

Anatomosurgical Implications Derived from an Embryological Study of the Scarpa's Triangle with Particular Reference to Groin Lymphadenectomy

“…This incorrect terminology does not compromise the efficacy of their surgical procedure but, as recently pointed out by Levenback et al [1], increases confusion in the names given to the various dissection practices mainly by the use of inappropriate terms in the definition of Scarpa's triangle anatomic landmarks.…”

“…Recently Levenback et al [1] have clearly shown that in the surgical management of vulval cancer among the gynecologic oncologists, important controversies regarding both the extent of the groin dissection and the name of the surgical procedures exist. These controversies are mainly due to the discrepancy between the anatomotopographic descriptions of the structures of Scarpa's triangle found in the classic anatomy textbooks [2][3][4][5] and the anatomical knowledges derived from the surgical practice.…”

“…Although Borgno et al [6] and Micheletti et al [7] studies added important knowledge on topographic distribution of Scarpa's lymph nodes, some discrepancies as remarked by Levenback and co-workers [1] still exist in their interpretation of the fascial structures of the Scarpa's triangle. Because of the need for a more precise anatomic and surgical terminology, as recently emphasized by some authors [1,9], the chance of having available some fetuses of different age, and the belief that combining anatomical and surgical expertise could improve clinical knowledge, we decided to reinvestigate, from an embryological point of view, the fascial structure and lymph node development of the inguinal region.…”

“…Because of the need for a more precise anatomic and surgical terminology, as recently emphasized by some authors [1,9], the chance of having available some fetuses of different age, and the belief that combining anatomical and surgical expertise could improve clinical knowledge, we decided to reinvestigate, from an embryological point of view, the fascial structure and lymph node development of the inguinal region.…”