Operative Morbidity Associated with Groin Dissections

Abstract

S-shaped incisions more often resulted in lymphatic collection and stagnation, with a higher incidence of wound infections and leg edema than straight incisions. Therefore, we now perform straight incisions to minimize the risk of wound infections and leg edema.

Video endoscopic inguinal lymphadenectomy for lymph node metastasis from solid tumors

“…49 Furthermore, wound complications after IL represent a significant cost to the health care system as they require prolonged wound care, which may sometimes require hospital re-admission and, in the case of extensive dehiscence/necrosis with exposure of the femoral vessels, return to the operating room for skin grafting or muscle transposition. 49,50 With the aim of prevention or minimization of postoperative morbidity after IL, several modifications to the original technique have been suggested. Techniques that limit the length or vary the type of incision (straight oblique incision, 6 double incision, 11 minimal access incisions 26 ) and other technical variants, including preservation of the saphenous vein, preservation of the muscle fascia, sartorious muscle transposition or omental flap 51 have been proposed.…”

Comparison of Positron Emission Tomography Scanning and Sentinel Node Biopsy in the Detection of Inguinal Node Metastases in Patients With Anal Cancer

“…However, the procedure has often been associated with high morbidity and prolonged hospital stay. Tonouchi et al (16) reported an overall wound infection rate of 24% and an incidence of moderate to severe infection of 16%. Compared with straight incisions, an S-shaped cutaneous incision seems to influence the incidence of volume of drain discharge.…”

“…Two other factors that contribute to wound complications are obesity and aging. Leg edema occurs in 40% of patients; pulmonary embolism has been reported in 0.6%-1.0% (16).…”

Surgical Management of M etastatic groin lymphadenopathyRetrospective study of 50 Cases in Regional Cancer Center

“…This straight oblique incision is superior to the straight vertical and S-shaped ("hockey stick") incisions, which are associated with an increased rate of postoperative complications (21) . Superficial inguinal lymph nodes in the previously described distribution are removed en bloc.…”