Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan.
Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan.
J Dermatol. 2022 Oct;49(10):1020-1026. doi: 10.1111/1346-8138.16502. Epub 2022 Jun 27.
Skin cancer patients with clinical nodal disease or whose positive sentinel nodes had great tumor burden remain candidates for regional lymph node dissections. Among these patients, inguinal or ilioinguinal lymph node dissection is frequently required in clinical practice, which is associated with significant postoperative morbidity-including lymphatic leakage. The aim of this retrospective study was to evaluate the efficacy of LigaSure™, an electrothermal bipolar vessel sealing system, in reducing lymphatic leakage in inguinal or ilioinguinal lymph node dissection. In total, 58 patients who received inguinal or ilioinguinal lymph node dissection (conventional group, 48; LigaSure™ group, 10) and shared similar characteristics were included in this study. Lymphatic leakage after drain removal was significantly lower in the LigaSure™ group than that in the conventional group (present ratio, 0% vs. 37%; p = 0.02). The daily lymphatic drainage volume also tended to be lower in the LigaSure™ than that in the conventional group, with significant differences on postoperative day 1 (p = 0.02). Other perioperative outcomes including the operating time, intraoperative blood loss, time to drain removal, duration of hospital stay, flap necrosis, and wound infection showed no significant differences between the two groups. The use of the LigaSure™ in inguinal or ilioinguinal lymph node dissection for the treatment of skin cancer could reduce the incidence of postoperative lymphatic leakage after drain removal.
皮肤癌患者有临床淋巴结疾病或其阳性前哨淋巴结有大肿瘤负担仍然是区域淋巴结清扫的候选者。在这些患者中,腹股沟或髂腹股沟淋巴结清扫术在临床实践中经常需要,这与显著的术后发病率有关,包括淋巴漏。本回顾性研究的目的是评估 LigaSure™(一种电热双极血管密封系统)在减少腹股沟或髂腹股沟淋巴结清扫术后淋巴漏中的疗效。共有 58 例接受腹股沟或髂腹股沟淋巴结清扫术(常规组 48 例,LigaSure™组 10 例)且具有相似特征的患者纳入本研究。LigaSure™组在拔除引流管后淋巴漏的发生率明显低于常规组(存在率为 0%比 37%;p=0.02)。LigaSure™组术后第 1 天的每日淋巴引流量也倾向于低于常规组,差异有统计学意义(p=0.02)。两组之间的其他围手术期结果,包括手术时间、术中出血量、引流管拔除时间、住院时间、皮瓣坏死和伤口感染,均无显著差异。在治疗皮肤癌的腹股沟或髂腹股沟淋巴结清扫术中使用 LigaSure™ 可降低拔除引流管后术后淋巴漏的发生率。