Surgical management of metastatic inguinal lymphadenopathy

Inguinal lymphadenectomy, or groin dissection, has a key role in the management of patients with penile, vulval, anal, and cutaneous malignancy. About 500 procedures are performed in the United Kingdom each year by general, gynaecological, plastic, and urological surgeons. Groin dissection is associ...

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Published inBMJ Vol. 329; no. 7477; pp. 1272 - 1276
Main Authors Swan, Marc C, Furniss, Dominic, Cassell, Oliver C S
Format Journal Article
LanguageEnglish
Published London British Medical Journal Publishing Group 27.11.2004
British Medical Association
BMJ Publishing Group LTD
BMJ Publishing Group
BMJ Group
EditionInternational edition
Subjects
Anatomy & physiology
Anus Neoplasms
Biological and medical sciences
Carcinoma, Squamous Cell - secondary
Clinical Review
Female
General aspects
Humans
Inguinal Canal - pathology
Inpatient care
Lymph node excision
Lymph Node Excision - methods
Lymph nodes
Lymphatic diseases
Lymphatic Metastasis - pathology
Lymphatic system
Male
Medical diagnosis
Medical sciences
Melanoma
Melanoma - secondary
Morbidity
Neoplasia
Penile Neoplasms
Postoperative complications
Prognosis
Sentinel lymph node biopsies
Sentinel Lymph Node Biopsy - methods
Skin Neoplasms
Squamous cell carcinoma
Surgery
Tumors
Vulva
Vulvar Neoplasms
Medicine
Clinical management
Treatment
Adenopathy
Surgery
Advanced stage
Metastatic
Malignant tumor
Inguinal
Metastasis
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Summary:Inguinal lymphadenectomy, or groin dissection, has a key role in the management of patients with penile, vulval, anal, and cutaneous malignancy. About 500 procedures are performed in the United Kingdom each year by general, gynaecological, plastic, and urological surgeons. Groin dissection is associated with high postoperative morbidity, chiefly related to wound healing and lymphoedema. As the preoperative diagnosis and postoperative care of these patients may also involve general practitioners, oncologists, dermatologists, and specialist nurses, this review is aimed at providing a concise yet comprehensive summary of the key aspects of managing inguinal lymph nodes. [PUBLICATION ABSTRACT]
Bibliography:local:bmj;329/7477/1272
Correspondence to: M C Swan
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Contributors: MCS and DF wrote the commentary, which was critically revised by OCSC. OCSC is guarantor.
Competing interests: MCS and OCSC are investigators for the Oxford Tisseel (Baxter Healthcare, Newbury, United Kingdom) trial; a prospective randomised controlled trial to determine whether fibrin sealant can reduce post-operative complications following axillary and inguinal lymphadenectomy. They receive no financial remuneration for their work.
Ethical approval: None required.
Acknowledgements: We thank the patients who consented to involvement with this review, and Nick White from Oxford Medical Illustration for his assistance with the clinical photographs.
Additional references w1-w16 are on bmj.com
Funding: None.
ISSN:0959-8138
0959-8146
1468-5833
1756-1833
DOI:10.1136/bmj.329.7477.1272