Baur Johannes, Mathe Katrin, Gesierich Anja, Weyandt Gerhard, Wiegering Armin, Germer Christoph-Thomas, Gasser Martin, Pelz Jörg O W
Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital Würzburg, Würzburg, Germany.
Department of Dermatology, Venerology and Allergology, University Hospital Würzburg, Würzburg, Germany.
World J Surg Oncol. 2017 May 11;15(1):99. doi: 10.1186/s12957-017-1164-x.
Inguinal lymph node dissection (LND) is a surgical procedure with a high morbidity rate. Variations in surgical procedure, such as sparing of the saphenous vein, have been proposed to reduce surgical morbidity. While sparing of the saphenous vein has shown promising results in earlier studies, data for this procedure in melanoma patients are rare. In this retrospective study, we report 10-year findings on the effects of saphenous vein-sparing LND on surgical morbidity and oncologic outcomes in melanoma patients.
A retrospective analysis of melanoma patients receiving inguinal LND in our facility between 2003 and 2013 was performed. Patients were divided into two groups: the saphenous vein resection group and the vein sparing group. Surgical morbidity, including wound infection, lymphatic fistula, severe bleeding, neurological complications, and chronic lymphedema, as well as regional recurrence-free survival were investigated.
A total of 106 patients were included in this study; of these, the saphenous vein was spared in 41 patients (38.7%). The rate of lymphatic fistula was 51.6 vs. 48.8%, wound infection occurred in 31.3 vs. 24.4%, and patients suffered from chronic lymphedema in 30.0 vs. 26.5% in V. saphena magna resection vs. sparing group. Differences observed, however, were not significant. No difference in regional recurrence-free survival between the two study groups was detected.
The results of our retrospective analysis could not confirm the promising results reported in earlier studies. Thus, sparing of the saphenous vein appears to be optional.
腹股沟淋巴结清扫术（LND）是一种发病率较高的外科手术。有人提出改变手术方式，如保留大隐静脉，以降低手术发病率。虽然在早期研究中保留大隐静脉已显示出有希望的结果，但黑色素瘤患者接受该手术的数据很少。在这项回顾性研究中，我们报告了保留大隐静脉的腹股沟淋巴结清扫术对黑色素瘤患者手术发病率和肿瘤学结局影响的10年研究结果。
对2003年至2013年在我们机构接受腹股沟淋巴结清扫术的黑色素瘤患者进行回顾性分析。患者分为两组：大隐静脉切除组和保留静脉组。研究了手术发病率，包括伤口感染、淋巴瘘、严重出血、神经并发症和慢性淋巴水肿，以及区域无复发生存率。
本研究共纳入106例患者；其中，41例患者（38.7%）的大隐静脉得到保留。大隐静脉切除组与保留组的淋巴瘘发生率分别为51.6%和48.8%，伤口感染发生率分别为31.3%和24.4%，慢性淋巴水肿发生率分别为30.0%和26.5%。然而，观察到的差异并不显著。两个研究组之间的区域无复发生存率没有差异。
我们的回顾性分析结果无法证实早期研究报告的有希望的结果。因此，保留大隐静脉似乎是可选择的。
