Although the utilization of videoscopic inguinal lymphadenectomy (VIL) reduces wound complications, other factors may reduce further complications in patients with melanoma and inguinal lymph node metastases. A timely diagnosis of disease at the microscopic stage via sentinel lymph node biopsy prior to the development of clinically palpable disease has been shown to decrease wound morbidity. For patients with clinically palpable disease, the utilization of fine-needle aspiration over excisional biopsy and avoiding incisions in the groin crease may reduce diagnostic-related morbidities.[29,30] Systematic postoperative care regimens consisting of early ambulation and compression stockings are crucial components to preventing complications such as lymphedema and deep venous thrombosis.
Aside from VIL, no other modified surgical technique has been shown to substantially reduce the morbidity associated with inguinal lymphadenectomy for metastatic melanoma. Other investigations have included a limited dissection based on primary location, saphenous vein preservation, omission of sartorius transposition, and a minimal access, two-incision technique. At this time, VIL is a feasible alternative to open inguinal lymphadenectomy for patients with melanoma and regional metastases. Long-term oncological outcomes are forthcoming.
Cancer Control. 2013;20(4):255-260. © 2013 H. Lee Moffitt Cancer Center and Research Institute, Inc.
Copyright by H. Lee Moffitt Cancer Center & Research Institute. All rights reserved.