Derby Royal Hospital, Derby, UK.
Int J Gynecol Cancer. 2011 Nov;21(8):1495-9. doi: 10.1097/IGC.0b013e318228f314.
To determine the complication rates associated with differing surgical techniques for groin node dissection for vulval cancer.
We performed a retrospective case note review of patients undergoing groin node dissection for vulval cancer between 2001 and 2009 at Nottingham University Hospitals NHS Trust.
Notes for 56 patients undergoing a total of 98 groin node dissections were examined. Sixty-four percent of the patients had at least one complication from surgery. The use of suction drains was not associated with an increase in complications. However, when drains were used, a short duration of use was associated with high rates of wound breakdown and a long duration of use was associated with higher rates of lymphedema. The use of staples for skin closure was associated with an increased risk of lymphocysts and chronic lymphedema. The greater the number of nodes collected at lymphadenectomy, the higher the risk of lymphocysts and lymphedema.
We recommend the use of subcuticular suture for wound closure. Patients who undergo lymphadenectomy with a node count per groin of more than 7 should be closely monitored for lymphedema and referred promptly to specialist services. The prolonged use of suction drainage may increase the risk of lymphedema.
确定不同外阴癌腹股沟淋巴结清扫术式相关的并发症发生率。
我们对 2001 年至 2009 年期间在诺丁汉大学医院 NHS 信托基金接受腹股沟淋巴结清扫术的外阴癌患者的病历进行了回顾性分析。
共检查了 56 名患者的 98 次腹股沟淋巴结清扫术的病历记录。64%的患者术后至少有一处并发症。使用负压引流并不增加并发症的发生。然而，当使用引流时，短时间使用与较高的伤口破裂率相关，长时间使用与较高的淋巴水肿发生率相关。使用订书钉进行皮肤缝合与发生淋巴囊肿和慢性淋巴水肿的风险增加相关。淋巴结清扫术时收集的淋巴结数量越多，发生淋巴囊肿和淋巴水肿的风险就越高。
我们建议使用皮下缝合线进行伤口闭合。对于每侧腹股沟淋巴结清扫术收集的淋巴结数量超过 7 个的患者，应密切监测淋巴水肿，并及时转介至专科服务。负压引流的长时间使用可能会增加淋巴水肿的风险。
