Limiting the morbidity of inguinal lymphadenectomy for XXXX .

@entity1 @entity4269 @entity281 @entity6783 @entity3 @entity1211 @entity320
BACKGROUND: Surgery is currently the primary treatment modality for @entity320 involving the inguinal lymph nodes. However, inguinal lymph node dissections are associated with substantial morbidity including @entity281 , wound @entity6783 , @entity4269 , @entity1211 ( @entity1211 ). Improved understanding is needed regarding the factors predisposing @entity1 to complications and the operative and perioperative maneuvers that can decrease morbidity. METHODS: We reviewed recently published literature regarding the morbidity associated with lymphadenectomy in the treatment of inguinal @entity320 . Where available, emphasis was focused on appropriately designed studies aimed at reducing treatment-related morbidity. When appropriate, the review was supplemented by our personal experience. RESULTS: Strategies to limit treatment-related morbidity involve optimizing the preoperative assessment, operative technique, and postoperative care. Establishing the diagnosis of nodal @entity3 early using minimally invasive techniques is critical to reduce subsequent perioperative complications. Morbidity is higher for inguinal compared to cervical or axillary lymphadenectomy, and many variations in extent of inguinal lymphadenectomy and operative technique have been reported. The lack of definitive trials has led to controversy regarding surgical technique such as indications for pelvic lymphadenectomy ("deep" node dissection), saphenous vein preservation, and sartorius transposition. In the postoperative period, the use of @entity1211 and @entity4269 should be considered to potentially improve @entity1 outcomes. CONCLUSIONS: While the morbidity of inguinal lymphadenectomy can be substantial, several straightforward pre- and postoperative measures can be instituted to limit morbidity. Controversy persists regarding the indications for and benefit of pelvic lymphadenectomy, saphenous vein preservation, and sartorius muscle transposition. A multi-institutional trial is currently in progress to investigate the safety of avoiding lymphadenectomy in @entity1 with microscopic @entity3 in the sentinel node.
