The role of reducing incision complications of surgical techniques used in groin lymphadenectomy for Vulval Malignancies

Background: Inguinal lymphadenectomy plays an important role in the cure of patients with inguinal metastasis from vulval cancer or prophylactic inguinal lymphadenectomy.Unfortunately, this treatment is often associated with multiple postoperative complications. This work set out to investigate the efficacy and tolerance of negative pressure without subcuticular suture versus routine manipulation after inguinal lymphadenectomy for patients with vulval malignancies Methods 75 patients with vulval malignancies were allocated into two groups depending on their clinical stages, with one of them (38 patients included, A group) being subjected to negative pressure drainage without subcuticular suture and the other (37 patients included, B group) to routine drainage with subcuticular suture after treated with inguinal lymphadenectomy. The operative time, seroma, hematoma, hemorrhage, wound infection, skin flap necrosis, were selected as the monitored parameters, through which the above two groups were compared with each other using t test, c 2 analysis. Results (1) The median operative time for unilateral inguinal lymphadenectomy was 49 min(33min～70 min ) in A group, compared to 63 min(50～85 min) in B group(P<0.01), and it was 3 min(2.5min～5min ) 12.5 min(7～15 min) for only incision closing time(P＜0.01). It was 11.7d of the flap healing time in A group and 20.9d in B group. Further, the time(d) of antibiotics usage was still different, 3d and 5.5d. (2) Short-term lower extremity lymphedema occurred with 18 patients (31.6%) in the A group and 24 patients (44.4%) in the B group (P>0.05). Still, flap necrosis was observed with 26 patients (10.5%) in A group while 11developed (20.4%) in B group (P<0.05), and the incision infection was observed in 4 (7%)patient in A group instead of 16(29.6%) in B group (P＜0.01). However, there was no statistical difference in postoperative fever, acute cellulites, seroma, or lymphocyst formation. (3) Discomfort occurrence rate decreased by about 50% in patients subjected to study group compared with those to control group, while there was no remarkable difference between two groups in the occurrence rates of drain block (P>0.05). Conclusion The application of negative drain technique during inguinal lymphadenectomy for patients with vulval malignancies could result in significant decrease in the occurrence of postoperative complications and good tolerance, and should be widely put into clinical practice.