Block dissection of inguinofemoral lymph nodes using separate "S" incision in surgical treatment of vulvar carcinoma

Abstract

Vulvar carcinomas account for almost 3-5% of all malignant tumors of the female genital organs. The primary therapeutic approach is surgical in all cases. Since 1994, we have used a separate "S" incision for inguinofemoral lymphadenectomy in the treatment of invasive vulvar carcinoma. In the period from 1985 to 2003, 46 patients with invasive forms of vulvar carcinoma were operated at the Department of Obstetrics and Gynecology in Novi Sad. Inguinofemoral lymphadenectomy was performed in 37 (84.4%) patients. During 1994, a wide "block" dissection of the vulva, mons pubis and inguinal area of a "butterfly" shape was performed, whereas during the following period, the operative area was reduced by application of separate inguinal "S" incisions leaving a tissue bridge in between. There were 5 patients with stage I, 1 with stage II and 4 with stage III carcinoma. By applying the technique of two separate inguinal "S" incisions we achieved shortening the intrahospital postoperative period to 14 days and reduction of the risk of wound dehiscence and postoperative complications in the period following 1994.