Solari Nicola, Bertoglio Sergio, Boscaneanu Alexandru, Minuto Michele, Reina Simona, Palombo Denise, Bruzzi Paolo, Cafiero Ferdinando
Department of Surgery, Surgery Unit 1, San Martino Hospital, Genoa, Italy.
Department of Surgical Sciences, University of Genoa, Genoa, Italy.
ANZ J Surg. 2019 Sep;89(9):1041-1044. doi: 10.1111/ans.15358. Epub 2019 Jul 31.
This study investigates the incidence of post-operative complications and risk factors of sentinel lymph node biopsy (SLNB) in melanoma patients.
A retrospective cohort study was conducted at a single cancer institution on 408 consecutive SLNBs.
Fifty-five post-operative complications occurred in 39 (9.5%) patients and included: wound infection in 24 (5.9%), seroma and lymphorrhea in 15 (3.7%), wound dehiscence in seven (1.7%), lymphocele in six (1.5%) and others in three (0.7%). Univariate analysis failed to identify possible risk factors (i.e. gender, age, lymph node region, number of excised lymph nodes, Breslow index, pT levels, comorbidities, length of surgery and hospital stay). Metastatic sentinel nodes occurred in four of 135 (3%) patients with thin melanoma (Breslow <1 mm) and in 68 of 262 (25.9%) patients with Breslow >1 mm.
For patients with thin melanoma in whom the incidence of lymph node metastasis is low, the reported post-operative morbidity of almost 10% of SLNB highlights the need for careful patient selection.
本研究调查黑色素瘤患者前哨淋巴结活检（SLNB）术后并发症的发生率及危险因素。
在一家癌症机构对连续408例SLNB进行了一项回顾性队列研究。
39例（9.5%）患者出现55例术后并发症，包括：伤口感染24例（5.9%）、血清肿和淋巴漏15例（3.7%）、伤口裂开7例（1.7%）、淋巴囊肿6例（1.5%）、其他3例（0.7%）。单因素分析未发现可能的危险因素（即性别、年龄、淋巴结区域、切除淋巴结数量、Breslow指数、pT水平、合并症、手术时长和住院时间）。135例Breslow厚度<1mm的薄型黑色素瘤患者中有4例（3%）前哨淋巴结转移，262例Breslow厚度>1mm的患者中有68例（25.9%）前哨淋巴结转移。
对于淋巴结转移发生率较低的薄型黑色素瘤患者，报道的SLNB术后近10%的发病率凸显了谨慎选择患者的必要性。
