Endoscopic inguinal lymphadenectomy with a novel abdominal approach to vulvar cancer: description of technique and surgical outcome.

STUDY OBJECTIVE

To evaluate the feasibility and surgical outcome of a novel technique of endoscopic inguinal lymphadenectomy to treat vulvar cancer.

DESIGN

Retrospective analysis performed by a single center over 2 years (Canadian Task Force classification II-2).

SETTING

Major university teaching hospital.

PATIENTS

The medical records for 17 consecutive patients who underwent endoscopic inguinal lymphadenectomy because of invasive vulvar cancer were retrospectively reviewed.

INTERVENTION

Endoscopic inguinal lymphadenectomy was performed using a novel abdominal approach.

MEASUREMENTS AND MAIN RESULTS

All patients underwent abdominal endoscopic inguinal lymphadenectomy without intraoperative complications. Median (range) operative time for the endoscopic procedure was 94 minutes, with estimated blood loss of approximately 137 mL (80-170 mL). A mean (range) of 16 (11-23) nodes were retrieved. In an additional 5 patients, pelvic node dissection was performed, with retrieval of 6 (3-11) nodes. Of the 17 patients, 2 demonstrated vulvar wound necrosis, and 1 exhibited lymphorrhea through the drain orifice. No other inguinal wound-related complications were observed. Mean postoperative hospital stay was 11 (8-19) days. All patients were followed up for more than 13 months, with no recurrence of cancer.

CONCLUSIONS

Endoscopic inguinal lymph node dissection using this novel abdominal approach in patients with vulvar cancer is a safe and feasible technique that may diminish the wound-related complications associated with the standard open approach.