Peter Dall1, Thomas Hildebrandt2, Andreas du Bois3, Eric Boetel4, Janine Ahlfaenger4, Matthias W Beckmann2, Mareike Bommert3. 1. Department of Gynecology and Obstetrics, Gynecological Oncology, Municipal Clinical Center Lüneburg, Bögelstrasse 1, 21339, Lüneburg, Germany. peter.dall@klinikum-lueneburg.de. 2. Department of Gynecology and Obstetrics, University Gynecological Cancer Center Franconia, Erlangen University Hospital, Friedrich Alexander University, Universitätsstrasse 21-23, 91054, Erlangen, Germany. 3. Department of Gynecology and Gynecologic Oncology, Evangelische Kliniken Essen-Mitte, Henricistraße 92, 45136, Essen, Germany. 4. Department of Gynecology and Obstetrics, Gynecological Oncology, Municipal Clinical Center Lüneburg, Bögelstrasse 1, 21339, Lüneburg, Germany.
Abstract
PURPOSE: Despite the introduction of sentinel node biopsy in patients with vulvar cancer, still approximately 50% of all patients have to undergo an inguinofemoral lymphadenectomy. This is associated with a high incidence of postoperative complications, which may be influenced by inguinal drain management. The aim of this study was to investigate the feasibility of a new surgical technique regarding drain management with an inguinoperitoneal drainage. METHODS: A retrospective analysis of 21 vulvar cancer patients with inguinofemoral lymphadenectomy was conducted. A silicone drain was circularly placed with the perforated end in the groin and the other end in the space of Douglas. The removal after 3 months was performed under local anesthesia. All patients were questioned during clinical follow-up regarding their personal experiences with the procedure, the occurrence of complications, and side effects using a clinical questionnaire. RESULTS: In 100% of the patients, the procedure was feasible. Regarding the number of groin punctures due to lymphocyst formation, 15 (71.4%) patients did not need any intervention and 3 (14.3%) patients needed 1-3 punctures. The patient satisfaction with the internal drainage was ranked as good by 17 (81.0%) patients and as moderate by 1 (4.8%) patient. In 3 (14.3%) patients, information about the number of groin punctures and the patient satisfaction were missing. CONCLUSION: Inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer patients is feasible and safe and a patient satisfaction of 81% is promising. For definitive conclusions regarding the efficacy of this technique, further investigations and prospective multicenter trials are needed.
PURPOSE: Despite the introduction of sentinel node biopsy in patients with vulvar cancer, still approximately 50% of all patients have to undergo an inguinofemoral lymphadenectomy. This is associated with a high incidence of postoperative complications, which may be influenced by inguinal drain management. The aim of this study was to investigate the feasibility of a new surgical technique regarding drain management with an inguinoperitoneal drainage. METHODS: A retrospective analysis of 21 vulvar cancer patients with inguinofemoral lymphadenectomy was conducted. A silicone drain was circularly placed with the perforated end in the groin and the other end in the space of Douglas. The removal after 3 months was performed under local anesthesia. All patients were questioned during clinical follow-up regarding their personal experiences with the procedure, the occurrence of complications, and side effects using a clinical questionnaire. RESULTS: In 100% of the patients, the procedure was feasible. Regarding the number of groin punctures due to lymphocyst formation, 15 (71.4%) patients did not need any intervention and 3 (14.3%) patients needed 1-3 punctures. The patient satisfaction with the internal drainage was ranked as good by 17 (81.0%) patients and as moderate by 1 (4.8%) patient. In 3 (14.3%) patients, information about the number of groin punctures and the patient satisfaction were missing. CONCLUSION: Inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer patients is feasible and safe and a patient satisfaction of 81% is promising. For definitive conclusions regarding the efficacy of this technique, further investigations and prospective multicenter trials are needed.
Entities:
Keywords:
Inguinofemoral lymphadenectomy; Inguinoperitoneal drainage; Postoperative complications; Vulvar cancer
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