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Feasibility of internal inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Despite the introduction of sentinel node biopsy in patients with vulvar cancer, still approximately 50% of all patients have to undergo an inguinofemoral lymphadenectomy. This is associated with a high incidence of postoperative complications, which may be influenced by inguinal drain management. The aim of this study was to investigate the feasibility of a new surgical technique regarding drain management with an inguinoperitoneal drainage.

Methods

A retrospective analysis of 21 vulvar cancer patients with inguinofemoral lymphadenectomy was conducted. A silicone drain was circularly placed with the perforated end in the groin and the other end in the space of Douglas. The removal after 3 months was performed under local anesthesia. All patients were questioned during clinical follow-up regarding their personal experiences with the procedure, the occurrence of complications, and side effects using a clinical questionnaire.

Results

In 100% of the patients, the procedure was feasible. Regarding the number of groin punctures due to lymphocyst formation, 15 (71.4%) patients did not need any intervention and 3 (14.3%) patients needed 1–3 punctures. The patient satisfaction with the internal drainage was ranked as good by 17 (81.0%) patients and as moderate by 1 (4.8%) patient. In 3 (14.3%) patients, information about the number of groin punctures and the patient satisfaction were missing.

Conclusion

Inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer patients is feasible and safe and a patient satisfaction of 81% is promising. For definitive conclusions regarding the efficacy of this technique, further investigations and prospective multicenter trials are needed.

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Author notes

  1. Peter Dall and Thomas Hildebrandt are contributed equally.

Authors and Affiliations

  1. Department of Gynecology and Obstetrics, Gynecological Oncology, Municipal Clinical Center Lüneburg, Bögelstrasse 1, 21339, Lüneburg, Germany

    Peter Dall, Eric Boetel & Janine Ahlfaenger

  2. Department of Gynecology and Obstetrics, University Gynecological Cancer Center Franconia, Erlangen University Hospital, Friedrich Alexander University, Universitätsstrasse 21–23, 91054, Erlangen, Germany

    Thomas Hildebrandt & Matthias W. Beckmann

  3. Department of Gynecology and Gynecologic Oncology, Evangelische Kliniken Essen-Mitte, Henricistraße 92, 45136, Essen, Germany

    Andreas du Bois & Mareike Bommert

Authors
  1. Peter Dall
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  2. Thomas Hildebrandt
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  3. Andreas du Bois
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  4. Eric Boetel
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  5. Janine Ahlfaenger
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  6. Matthias W. Beckmann
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  7. Mareike Bommert
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Contributions

PD: project development, data collection, manuscript editing. TH: data collection, data analysis, manuscript writing/editing. AdB: data analysis, manuscript editing. EB: protocol/project development. JA: data collection, data analysis. MWB: protocol, manuscript writing/editing. MB: data analysis, manuscript writing/editing.

Corresponding author

Correspondence to Peter Dall.

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Conflict of interest

PD, TH, AdB, EB, JA, MWB and MB declare no conflict of interest related to this manuscript. AdB receiving advisory fees from AstraZeneca, Roche, Tesaro, Clovis, BioCad, Genmab, and Pfizer. MB reports non-financial support from prIME Oncology (travel support), outside the submitted work.

Ethical approval

All procedures performed in the survey involving human participants were in accordance with the ethical standards of institutional and national research committee (Ethic Committee of Friedrich Alexander University of Erlangen–Nuremberg). The study does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Dall, P., Hildebrandt, T., du Bois, A. et al. Feasibility of internal inguinoperitoneal drainage after inguinofemoral lymphadenectomy in vulvar cancer. Arch Gynecol Obstet 301, 1513–1519 (2020). https://doi.org/10.1007/s00404-020-05528-z

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  • DOI: https://doi.org/10.1007/s00404-020-05528-z

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