Inguinal and Pelvic Lymphadenectomy

Abstract

Groin lymphadenectomy is comprised of two separate lymph node groups: inguinal and pelvic. The inguinal nodes are located in the femoral triangle, based on the inguinal ligament with its apex formed by the crossing of the adductor longus and the sartorius muscles. The pelvic component of the dissection includes the lymph nodes in a triangular area whose apex is formed by the bifurcation of the common iliac artery and whose base is essentially the fascia over the obturator foramen. If the inguinal lymphadenectomy specimen is negative for metastases from the primary malignant melanoma or epidermoid carcinoma of the skin of the extremities or lower trunk, performing the pelvic dissection is probably unnecessary because the incidence of positive nodes will then be less than 5% (Holmes et al.).