Mukur Dipi Ray1, Ashish Jakhetiya2, Sunil Kumar1, Ashutosh Mishra1, Seema Singh1, Nootan Kumar Shukla1. 1. Department of Surgical Oncology, Dr BRA-IRCH, All India Institute of Medical Sciences, New Delhi, India. 2. Department of Cancer Surgery, Vardhman Mahavir Medical college (VMMC) and Safdarjung Hospital, Ansari Nagar, New Delhi, India. ashish_jakhetiya@yahoo.com.
Abstract
INTRODUCTION: Historically, groin dissections are associated with high morbidity. Various modifications have been described in the literature with inconsistent outcomes. The aim of this paper is to highlight modified skin bridge technique to minimize all post-operative complications of groin dissection without compromising early oncological outcomes. METHODS: A retrospective descriptive study of the computerized cancer database was performed to retrieve details of all the cancer patients who had undergone groin dissections during January 2012 to September 2016. Data pertaining to clinical profile including demographics, clinical and histopathological details, treatment profile, procedure-related morbidity and relapse patterns were extracted and analysed. RESULTS: A total of 75 patients underwent 105 groin dissections during this period. Out of 105 groin dissections, 43 were inguinal lymph node dissection (ILND) and 62 were combined ilio-inguinal lymph node dissection (IILND). The most common diagnosis was carcinoma penis (25%) followed by malignant melanoma (14.6%) and squamous cell carcinoma (13.33%) of lower extremities. Overall, the most common complications were seroma (14.28%) and skin edge necrosis (7.61%) followed by surgical site infection (4.76%). After a median follow-up of 17.64 months (IQR 5-61.53), a total of 18 patients (24%) developed recurrence. CONCLUSION: Groin dissection still remains an important diagnostic as well as therapeutic procedure justifying its potential of morbidity. Modified skin bridge technique is a very effective method to minimize all post-operative complications with optimal early oncological outcomes.
INTRODUCTION: Historically, groin dissections are associated with high morbidity. Various modifications have been described in the literature with inconsistent outcomes. The aim of this paper is to highlight modified skin bridge technique to minimize all post-operative complications of groin dissection without compromising early oncological outcomes. METHODS: A retrospective descriptive study of the computerized cancer database was performed to retrieve details of all the cancerpatients who had undergone groin dissections during January 2012 to September 2016. Data pertaining to clinical profile including demographics, clinical and histopathological details, treatment profile, procedure-related morbidity and relapse patterns were extracted and analysed. RESULTS: A total of 75 patients underwent 105 groin dissections during this period. Out of 105 groin dissections, 43 were inguinal lymph node dissection (ILND) and 62 were combined ilio-inguinal lymph node dissection (IILND). The most common diagnosis was carcinoma penis (25%) followed by malignant melanoma (14.6%) and squamous cell carcinoma (13.33%) of lower extremities. Overall, the most common complications were seroma (14.28%) and skin edge necrosis (7.61%) followed by surgical site infection (4.76%). After a median follow-up of 17.64 months (IQR 5-61.53), a total of 18 patients (24%) developed recurrence. CONCLUSION: Groin dissection still remains an important diagnostic as well as therapeutic procedure justifying its potential of morbidity. Modified skin bridge technique is a very effective method to minimize all post-operative complications with optimal early oncological outcomes.
Authors: Robert S Svatek; Mark Munsell; Jordan M Kincaid; Paul Hegarty; Joel W Slaton; J Erik Busby; Kris E Gaston; Philippe E Spiess; Lance C Pagliaro; Pheroze Tamboli; Curtis A Pettaway Journal: J Urol Date: 2009-10-17 Impact factor: 7.450