The Pedicled Flap of Adductor Longus, a New Technique for Inguinal Reconstruction

Introduction: Reconstruction surgeries of the inguinal area pose a challenge for oncological and orthopedic surgeons, especially after radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both. Although numerous surgical procedures have been reported, there is no report about a pedicle adductor longus flap method. The aim of this work is to show our experience about inguinal reconstruction with pedicled adductor longus flap and associated outcomes.Patients and Methods: A retrospective study of 16 patients with localized inguinal region interventions and reconstructed by adductor longus flap from March 2016 to July 2020. Patients' average age was 60.0 years (range = 38–79 years) and had postoperative follow-up of 10 months (ranging 2–19 months). All patients had unilateral inguinal region involvement—seven cases on the left and nine cases on the right. The patients' clinical course, operative course, and postoperative follow-up data were evaluated.Results: All 16 patients recovered well post-operatively and did not require any re-intervention. Four patients experienced negligible discomfort around the groin area. Five patients experienced a minor strength deficit in thigh adduction compared with that of preoperative strength in the same or contralateral leg. The aforementioned complications resolved during the postoperative course and had no functional impact on their activity of daily living. All adductor longus flaps survived, completely filled the inguinal dead space, and wounds healed uneventfully within 3 weeks except for three patients who suffered delayed wound healing for more than 4 weeks. Other common complications such as infection, seroma, or wound dehiscence were not encountered in this series.Conclusion: The adductor longus flap is a reliable alternative method for inguinal region reconstruction following radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both.

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Conventional radiotherapy and intensity-modulated radiotherapy in carcinoma vulva: An experience from a tertiary medical center of India

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_66_17 ◽

2019 ◽

Vol 08 (01) ◽

pp. 41-43 ◽

Cited By ~ 1

Author(s):

Koustav Mazumder ◽

Arun Elangovan ◽

Bhavana Rai ◽

Vanita Suri ◽

Vanita Jain ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Intensity Modulated Radiotherapy ◽

Disease Free Survival ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Conventional Radiotherapy ◽

Free Survival

Abstract Context: Vulvar cancer is one of the uncommon gynecological malignancies. Multimodality treatment with surgery, radiotherapy, and chemotherapy are required for treatment of the disease. Aims: The aim of the study was to evaluate clinical outcome in patients of carcinoma vulva, treated at our institution. Subjects and Methods: This was a retrospective-cohort study done in 50 patients with squamous cell carcinoma of the vulva, treated at our institution from January 2008 to December 2014. Data were analyzed on the basis of age, stage, type of treatment received, and treatment-related toxicity. Disease-free survival and overall survival were estimated. Statistical Analysis Used: Kaplan–Meier survival analysis and Chi-square test were used for statistical analysis. Results: Majority of the patients (52%) had presented with Stage III disease. Thirty-six of 50 patients underwent surgery: simple vulvectomy – 2, radical vulvectomy – 34, bilateral inguinal lymph node dissection was done in 32 patients, and 1 patient underwent ipsilateral-inguinal lymph node dissection. Among 40 patients who received radiotherapy and eight patients received palliative radiotherapy. Seventeen patients underwent intensity-modulated radiotherapy (IMRT) and 15 patients received conventional radiotherapy. Significantly less Grade 2 or more skin toxicity (P = 0.003) observed in patients who underwent IMRT. Among non-IMRT group, eight patients required treatment break during radiation. At a median follow-up time of 25.5 months, median overall survival was 31 months and median disease-free survival was 25 months. About 42% patients were alive and free of disease at last follow-up. Conclusions: Modified radical vulvectomy with inguinal lymph node dissection followed by radiotherapy is the mainstay of management of locally advanced carcinoma vulva. Using IMRT, we could minimize the treatment related radiation toxicity and treatment breaks.

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Follow up of preliminary results of minimally invasive inguinal lymph node dissection in Egypt

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2018.10.271 ◽

2019 ◽

Vol 45 (2) ◽

pp. e74

Author(s):

H. Abdel Mageed A. Motaal ◽

M. Gamil Ramadan ◽

M. mohamed safa ◽

A. mostafa mahmoud ◽

I. saad hussein

Keyword(s):

Lymph Node ◽

Minimally Invasive ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Preliminary Results

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1007: Simultaneous Inguinal Lymph Node Dissection and Penile Surgery in Patients with Carcinoma of Penis: Experience from Tata Memorial Hospital, Mumbai, India

The Journal of Urology ◽

10.1016/s0022-5347(18)31235-7 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 332-333 ◽

Cited By ~ 1

Author(s):

Yuvaraja B. Thyavihally ◽

Hemant B. Tongaonkar

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Memorial Hospital ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Tata Memorial Hospital

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Reduction of postoperative morbidity after radical inguinal lymph node dissection in vulvar cancer using internal inguino-peritoneal drains

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0036-1592978 ◽

2016 ◽

Vol 76 (10) ◽

Author(s):

P Dall ◽

E Boetel ◽

J Ahlfänger ◽

G Mehlhorn ◽

SP Renner ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Postoperative Morbidity ◽

Vulvar Cancer ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection

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Benefit of skin ultrasound examination in determining the area of inguinal lymph node dissection

The Journal of Dermatology ◽

10.1111/1346-8138.12236 ◽

2013 ◽

Vol 40 (9) ◽

pp. 765-766

Author(s):

Tomoko Kobayashi ◽

Kenji Yokota ◽

Masaki Sawada ◽

Takaaki Matsumoto ◽

Masashi Akiyama

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Ultrasound Examination ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Skin Ultrasound

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Prevention of Seroma After Inguinal Lymph Node Dissection by TachoSil Application: A Pilot Study

Clinical Skin Cancer ◽

10.1016/j.clsc.2017.08.005 ◽

2017 ◽

Vol 2 (1-2) ◽

pp. 5-9

Author(s):

Roel Henneman ◽

Michel W.J.M. Wouters ◽

Alexander C.J. van Akkooi ◽

Sylvia ter Meulen ◽

Alfons J.M. Balm ◽

...

Keyword(s):

Lymph Node ◽

Pilot Study ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection

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Video-endoscopic radical inguinal lymph node dissection for a patient with vulvar cancer

Gynecology and Pelvic Medicine ◽

10.21037/gpm.2019.12.10 ◽

2020 ◽

Vol 3 ◽

pp. 4-4

Author(s):

Yue Yang ◽

Jiafeng Zheng ◽

Lu Huang ◽

Xiaoyan Liao ◽

Li He ◽

...

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Vulvar Cancer ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection

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Surgical Advances in Inguinal Lymph Node Dissection

Urologic Clinics of North America ◽

10.1016/j.ucl.2016.06.007 ◽

2016 ◽

Vol 43 (4) ◽

pp. 457-468 ◽

Cited By ~ 6

Author(s):

Pranav Sharma ◽

Homayoun Zargar ◽

Philippe E. Spiess

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection

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Infectious Morbidity After Radical Vulvectomy

Infectious Diseases in Obstetrics and Gynecology ◽

10.1155/s1064744994000529 ◽

1994 ◽

Vol 2 (3) ◽

pp. 130-135 ◽

Cited By ~ 3

Author(s):

Steven A. Elg ◽

Linda F. Carson ◽

Doris C. Brooker ◽

Jonathan R. Carter ◽

Leo B. Twiggs

Keyword(s):

Lymph Node ◽

Lymph Node Dissection ◽

Postoperative Infection ◽

Inguinal Lymph Node ◽

Tumor Stage ◽

Cancer Type ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Infectious Morbidity ◽

Radical Vulvectomy

Objective: This retrospective investigation describes the infectious morbidity of patients following radical vulvectomy with or without inguinal lymph node dissection.Methods: The charts of patients undergoing radical vulvectomy between January 1, 1986, and September 1, 1989, were reviewed for age, weight, cancer type, tumor stage, operative procedure(s), prophylactic antibiotic and its length of use, febrile morbidity, infection site, culture results, significant medical history, and length of use and number of drains or catheters used.Results: The study group was composed of 61 patients, 14 of whom underwent a radical vulvectomy and 47 who also had inguinal lymph node dissection performed. Twenty-nine patients (48%) had at least 1 postoperative infection. Five patients (8%) had 2 or more postoperative infections. The site and incidence of the infections were as follows: urinary tract 23%, wound 23%, lymphocyst 3%, lymphatics (lymphangitis) 5%, and bowel (pseudomembranous colitis) 3%. The most common pathogens isolated from both urine and wound sites were Pseudomonas aeruginosa, enterococcus, and Escherichia coli. A significant decrease in wound infection was demonstrated when separate incisions were made for inguinal lymph node dissection (P <0.05). The mean number of days to onset of postoperative infection for wound, urine, lymphatics, lymphocyst, and bowel were 11, 8, 57, 48, and 5, respectively.Conclusions: We conclude that the clinical appearance of post-radical vulvectomy infections is delayed when compared with other post-surgical wound infections. Second, utilizing separate inguinal surgical incisions may reduce infectious morbidity. Finally, tumor stage and type do not necessarily increase the infectious morbidity of radical vulvar surgery.

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