Ray Mukur Dipi, Jakhetiya Ashish, Kumar Sunil, Mishra Ashutosh, Singh Seema, Shukla Nootan Kumar
Department of Surgical Oncology, Dr BRA-IRCH, All India Institute of Medical Sciences, New Delhi, India.
Department of Cancer Surgery, Vardhman Mahavir Medical college (VMMC) and Safdarjung Hospital, Ansari Nagar, New Delhi, India.
World J Surg. 2018 Oct;42(10):3196-3201. doi: 10.1007/s00268-018-4604-z.
Historically, groin dissections are associated with high morbidity. Various modifications have been described in the literature with inconsistent outcomes. The aim of this paper is to highlight modified skin bridge technique to minimize all post-operative complications of groin dissection without compromising early oncological outcomes.
A retrospective descriptive study of the computerized cancer database was performed to retrieve details of all the cancer patients who had undergone groin dissections during January 2012 to September 2016. Data pertaining to clinical profile including demographics, clinical and histopathological details, treatment profile, procedure-related morbidity and relapse patterns were extracted and analysed.
A total of 75 patients underwent 105 groin dissections during this period. Out of 105 groin dissections, 43 were inguinal lymph node dissection (ILND) and 62 were combined ilio-inguinal lymph node dissection (IILND). The most common diagnosis was carcinoma penis (25%) followed by malignant melanoma (14.6%) and squamous cell carcinoma (13.33%) of lower extremities. Overall, the most common complications were seroma (14.28%) and skin edge necrosis (7.61%) followed by surgical site infection (4.76%). After a median follow-up of 17.64 months (IQR 5-61.53), a total of 18 patients (24%) developed recurrence.
Groin dissection still remains an important diagnostic as well as therapeutic procedure justifying its potential of morbidity. Modified skin bridge technique is a very effective method to minimize all post-operative complications with optimal early oncological outcomes.
从历史上看,腹股沟清扫术与高发病率相关。文献中描述了各种改良方法,但其结果并不一致。本文的目的是强调改良皮肤桥技术,以在不影响早期肿瘤学结果的前提下,将腹股沟清扫术的所有术后并发症降至最低。
对计算机化癌症数据库进行回顾性描述性研究,以检索2012年1月至2016年9月期间所有接受腹股沟清扫术的癌症患者的详细信息。提取并分析了与临床资料相关的数据,包括人口统计学、临床和组织病理学细节、治疗情况、手术相关发病率和复发模式。
在此期间,共有75例患者接受了105次腹股沟清扫术。在105次腹股沟清扫术中,43次为腹股沟淋巴结清扫术(ILND),62次为髂腹股沟淋巴结联合清扫术(IILND)。最常见的诊断是阴茎癌(25%),其次是恶性黑色素瘤(14.6%)和下肢鳞状细胞癌(13.33%)。总体而言,最常见的并发症是血清肿(14.28%)和皮肤边缘坏死(7.61%),其次是手术部位感染(4.76%)。中位随访17.64个月(四分位间距5 - 61.53个月)后,共有18例患者(24%)出现复发。
腹股沟清扫术仍然是一项重要的诊断和治疗方法,其发病率虽高但仍有其合理性。改良皮肤桥技术是一种非常有效的方法,可将所有术后并发症降至最低,并取得最佳的早期肿瘤学结果。