Abstract:
INTRODUCTION:Inguinal lymphadenectomy for metastatic melanoma is reported to have a complication rate as high as 50%. Wound dehiscence has been reported to occur in more than half of these patients, and as a result many surgeons routinely use sartorius muscle transposition to protect against the potential for exposed vessels. We report feasibility of minimally invasive inguinal lymphadenectomy intended to minimize wound complications inherent to this procedure. METHODS:Five patients with histologically confirmed inguinal metastases from melanoma underwent minimally invasive inguinal lymphadenectomy. Procedures were performed via three ports: one at the apex of the femoral triangle, a second two fingerbreadths medial to the adductors, and the third two fingerbreadths lateral to the sartorius. No inguinal incision was utilized for the purpose of surgery. A standard melanoma dissection was performed through these ports: contents of the femoral triangle and 5 cm up onto the external oblique aponeurosis were removed. To validate this technique, sentinel node biopsy scars were excised to permit visual confirmation of adequate anatomic dissection. RESULTS:Five patients underwent minimally invasive inguinal lymphadenectomy for metastatic melanoma. Median operative time was 180 (range, 142-223) min, median hospital stay was 1 day, and two patients developed cutaneous erythema but neither suffered wound dehiscence. Median nodal yield was 10 (range, 4-13). Blood loss was <100 ml for all procedures. Median duration of drain usage was 8 (range 7-19) days. CONCLUSIONS:Minimally invasive inguinal lymphadenectomy is feasible for patients with melanoma as demonstrated by nodal yield and visual inspection. This technique may reduce complication rates and wound dehiscence, and the risk of exposed vessels is minimized by eliminating the inguinal incision. This obviates the need for routine sartorius muscle transposition. A prospective, randomized trial comparing the open versus the videoscopic approach is currently in progress.
journal_name
Ann Surg Oncoljournal_title
Annals of surgical oncologyauthors
Delman KA,Kooby DA,Ogan K,Hsiao W,Master Vdoi
10.1245/s10434-009-0816-7subject
Has Abstractpub_date
2010-03-01 00:00:00pages
731-7issue
3eissn
1068-9265issn
1534-4681journal_volume
17pub_type
杂志文章abstract:OBJECTIVE:The main goal of the current study was to compare survival differences among subgroups of primary ovarian cancer patients in International Federation of Gynecology and Obstetrics (FIGO) stages IIIC and IIIA1 after complete tumor debulking surgery. METHODS:A total of 218 patients with primary ovarian cancer w...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4959-4
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:The clinical implications and contemporary management of T1b penile cancer are unknown. National treatment guidelines advocate surgical lymph node examination (SLNE) for T1b disease. OBJECTIVE:The aim of this study was to evaluate the prognosis of T1b disease and adherence to corresponding treatment guideli...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2013-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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更新日期:2007-07-01 00:00:00
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更新日期:2020-09-30 00:00:00
abstract:BACKGROUND:Current understanding of the lymphatic system of the breast is derived mainly from the work of the anatomist Sappey in the 1850s, with many observations made during the development and introduction of breast lymphatic mapping and sentinel node biopsy contributing to our knowledge. METHODS:Twenty four breast...
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pub_type: 杂志文章
doi:10.1245/s10434-007-9709-9
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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doi:10.1245/s10434-018-6634-z
更新日期:2018-09-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-08-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 临床试验,杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,meta分析
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更新日期:2014-03-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2009-01-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-009-0625-z
更新日期:2009-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1245/s10434-008-0062-4
更新日期:2008-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1245/s10434-015-4592-2
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:Recently, ultrasound (US)-guided needle biopsy has been proposed as an acceptable alternative to open biopsy in women with nonpalpable breast masses. This study evaluated the accuracy of US-guided needle biopsy of nonpalpable breast masses performed by surgeons at the time of the initial clinical examination...
journal_title:Annals of surgical oncology
pub_type: 杂志文章
doi:10.1007/BF02305766
更新日期:1996-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2018-11-01 00:00:00
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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journal_title:Annals of surgical oncology
pub_type: 杂志文章,多中心研究
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更新日期:2008-02-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2017-10-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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abstract:: ...
journal_title:Annals of surgical oncology
pub_type: 评论,杂志文章
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更新日期:2018-12-01 00:00:00
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journal_title:Annals of surgical oncology
pub_type: 杂志文章
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更新日期:2008-10-01 00:00:00