Abstract
The aim of the study was to evaluate whether complication rate, costs, operation times, and hospitalization times differed in two different patient groups: in group 1, frozen section analysis of the sentinel lymph node and lymph node dissection were carried out in the same operation. In group 2, normal investigation of the sentinel lymph node and lymph node dissection were done in a second operation. One hundred thirty-five patients with cutaneous melanoma were included. Hospitalization times, costs, complication rates, and operation times of two-stage and one-stage lymph node dissection of the draining area after detection of metastases in the sentinel lymph node were retrospectively compared. Lymph node metastasis in the sentinel lymph node was found in 23 patients. In 11 patients, removal of the sentinel lymph node and dissection of the lymph node basin was performed in the same operation. In 12 patients, a two-stage procedure was the treatment of choice. Operation times were not different in the two groups (p=0.87) while two-stage operation patients were hospitalized significantly longer (14.2 ± 9.7 vs 23.9 ± 24 days; p=0.01) and costs were significantly higher (7,836.90 ± 2,397.95 Swiss francs vs 5,279.40 ± 1,994.90 Swiss francs). In addition, more complications were found in the two-stage group.
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Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran AJ (1992) Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127(4):392–399
Stanley P (2000) The role of sentinel lymph nodes in malignant melanoma. Surg Clin North Am 80(6):1741–1757
Koopal SA, Tiebosch AT, Albertus Piers D, Plukker JT, Schraffordt Koops H, Hoekstra HJ (2000) Frozen section analysis of sentinel lymph nodes in melanoma patients. Cancer 89(8):1720–1725
Viale G, Bosari S, Mazzarol G, Galimberti V, Luini A, Veronesi P, Paganelli G, Bedoni M, Orvieto E (1999) Intraoperative examination of axillary sentinel lymph nodes in breast carcinoma patients. Cancer 85(11):2433–2438
van Diest PJ, Peterse HL, Borgstein PJ, Hoekstra O, Meijer CJ (1999) Pathological investigation of sentinel lymph nodes. Eur J Nucl Med 26[Suppl 4]:S43–S49
Bland KI, Klamer TW, Polk HC Jr, Knutson CO (1981) Isolated regional lymph node dissection: morbidity, mortality and economic considerations. Ann Surg 193(3):372–376
Urist MM, Maddox WA, Kennedy JE, Balch CM (1983) Patient risk factors and surgical morbidity after regional lymphadenectomy in 204 melanoma patients. Cancer 51(11):2152–2156
Karakousis CP, Heiser MA, Moore RH (1983) Lymphedema after groin dissection. Am J Surg 145(2):205–208
Karakousis CP, Emrich LJ, Rao U (1986) Groin dissection in malignant melanoma. Am J Surg 152(5):491–495
Baas PC, Schraffordt Koops H, Hoekstra HJ, van Bruggen JJ, van der Weele LT, Oldhoff J (1992) Groin dissection in the treatment of lower-extremity melanoma: short-term and long-term morbidity. Arch Surg 127(3):281–286
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von Känel, O.E.C., Haug, M. & Pierer, G. One-stage versus two-stage lymph node dissection after investigation of sentinel lymph node in cutaneous melanoma: a comparison of complications, costs, hospitalization times, and operation times. Eur J Plast Surg 27, 347–350 (2005). https://doi.org/10.1007/s00238-004-0695-x
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DOI: https://doi.org/10.1007/s00238-004-0695-x