Department of Dermatology, Venereology and Allergology, University of Göttingen, Robert-Koch-Straße 3, Göttingen, Germany.
J Dtsch Dermatol Ges. 2012 Oct;10(10):733-9. doi: 10.1111/j.1610-0387.2012.07941.x. Epub 2012 Jun 12.
Risk-factors for leg swelling following primary melanoma excision and inguinal sentinel lymphadenectomy (SLNE) have not been sufficiently investigated.
We prospectively studied three parameters in 105 subjects: 1) subjectively perceived swelling, 2) clinically diagnosed swelling and 3) photo-optical measurement of volume differences between both legs.
Perceived swelling, clinically diagnosed swelling, and manifest edema occurred in 31%, 15%, and 7% of patients respectively. Following inguinal SLNE, there was a mean volume increase of 1.5% in the operated leg. Both the lower leg and the thigh increased in volume. Obesity, primary melanoma location on the lower leg, and inguinal seromas were identified as significant risk factors for postoperative swelling. Wider excision margins around a primary melanoma on the thigh were also associated with a significant increase in volume. Age, sex, the number of sentinel lymph nodes, the drainage fluid volume, and the time since SLNE were non-significant.
Both inguinal SLNE and primary melanoma excision may contribute to minimal fluid accumulation in the leg. More than two-thirds of patients did not have any swelling. Obesity, location of the primary melanoma at a distal site on the leg, a wide safety margin, and seromas are associated with postoperative leg swelling.
原发性黑色素瘤切除和腹股沟前哨淋巴结活检（SLNE）后腿部肿胀的风险因素尚未得到充分研究。
我们前瞻性研究了 105 名受试者的三个参数：1）主观感知肿胀，2）临床诊断肿胀，3）双腿之间体积差异的光光学测量。
分别有 31%、15%和 7%的患者出现感知肿胀、临床诊断肿胀和明显水肿。腹股沟 SLNE 后，手术侧腿的平均体积增加了 1.5%。小腿和大腿都增加了体积。肥胖、小腿原发性黑色素瘤位置和腹股沟血清肿被确定为术后肿胀的显著危险因素。大腿上原发性黑色素瘤切除边缘较宽也与体积显著增加相关。年龄、性别、前哨淋巴结数量、引流液量和 SLNE 时间无显著意义。
腹股沟 SLNE 和原发性黑色素瘤切除都可能导致腿部少量积液。超过三分之二的患者没有任何肿胀。肥胖、小腿远端位置的原发性黑色素瘤、宽安全边界和血清肿与术后腿部肿胀有关。
