Postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate groin incisions

Abstract

The focus of this study was to document postoperative complications after vulvectomy and inguinofemoral lymphadenectomy using separate incisions. Data from 172 consecutive patients with newly diagnosed carcinoma of the vulva were studied. One hundred and one patients primarily treated with modified radical vulvectomy and complete inguinofemoral lymphadenectomy using separate groin incisions (n = 187) were included in this study. One or more complications were documented in 77 of the 101 (76%) patients. Complications after groin dissection were observed in 66% of the patients. The main complications were wound breakdown (17%) and/or infection (39%) of the groin, lymphocyst formation (40%), and lymphedema (28%). In 98 of 187 (52%) groin dissections, one or more complications were documented. The presence of lymph node metastases, postoperative radiation, age older than 65 years, and removal of the vena saphena magna were not significant risk factors for the occurrence of complications. The occurrence of early complications after groin dissection was significantly related to the late-complication lymphedema (P = 0.002). Our results confirm relatively high rates of wound breakdown, infection, lymphocyst formation, and lymphedema even with separate groin incisions. The occurrence of early complications was related to lymphedema. No other risk factors could be identified.

Comparison of Outcome after Sentinel Lymph Node Biopsy or Inguinal Lymph Node Dissection in Patients with Nodal Negative Squamous Vulvar Cancer

“…The SLNB concept has been adapted from other malignancies, reducing surgical mortality with slightly higher groin recurrence rates [15]. Lymphedema is one of the major complications after a ILND effecting up to 70% of the patients [20,21]. With removal of only SLN, lymph-edema rates dropped from 25.2 to 1.9 percent [20].…”

Lymphoedema Vulva

“…More often lymphoedema is a result of treatment, either surgical excision of draining lymphnodes and / or radiotherapy [3]. Lymphoedema of the vulva can be a postoperative complication after vulvectomy and inguino femoral lymphadenectomy [4]. Vulval lymphoedema can be a rare extra-intestinal manifestation of Crohn's disease [5,6] but the ulcer in such cases shows epitheloid and giant cell granulomas.…”

Invasive Cancer of the Vulva: Clinical and Therapeutic Aspects in the Gynecology and Obstetrics Service at Donka Hospital, Guinea- Conakry

“…And vulva surgery presented total of 20% complication [18]. The efficiency of the surgical method of care is satisfactory for the located stage, with a total recidivating of 1-10% [7].…”