Heintzen, M.J. ( Maximilian J.) (2017) Evaluation of videoscopic inguinal and iliac lymph node dissection in melanoma patients with special focus on the perioperative events. thesis, Medicine.
Full text available on request.Abstract
Background.. An open lymph node dissection is considered standard of care in case of a metastasis in the groin region in melanoma patients. The conventional open surgery is a procedure that is accompanied with a high rate of postoperative complications, up to 50%. The most common complications include infection, seroma, insufficient wound healing and early lymphedema. Since the complications rate is so high, this triggered the quest for a new and improved approach. An alternative treatment option is the videoscopic approach. In 2015 this approach was introduced at the University Medical Center in Groningen. The aim of our research was to evaluate the videoscopic lymphadenectomy. Methods. Prospective data were collected on 16 melanoma patients with inguinal metastases for which a videoscopic inguinal lymphadenectomy was performed. This group of patients was compared to a historical cohort of 142 patients who underwent an open lymphadenectomy, regarding pathologic and intra-operative characteristics. The primary outcome measure was the oncological outcome measured by the number of harvested lymph nodes. The secondary outcome parameter was operation time and possible correlations. Results. Patient characteristics were similar in the two cohorts with no statistically significant differences in patient age, gender, BMI or smoking status. Also, the pathological data of the primary melanoma were non-significantly different in comparison. The harvest of lymph nodes was significantly smaller in the videoscopic group with a median lymph node harvest of 7.5 (IQR: 3,5-9), than in the conventional group with a median harvest of 10 (IQR: 7-13) nodes. The median of the maximum size measurement of metastasized lymph node in the videoscopic group was 20 mm (IQR: 4,5-42,5), and 18mm (IQR: 4,1-35,0) in the control group. No significant correlation was found between the factors operation time, BMI and lymph nodes harvested. The operation time for the videoscopic procedure showed a median of 159 minutes, ranging from 83 minutes to 279 minutes. Conclusions. Videoscopic inguinal lymphadenectomy is an alternative new approach to the traditional open lymphadenectomy. Our study showed a significantly lower lymph node retrieval whilst using the new technique, however, further research on a broader spectrum is required to make a qualified statement over the efficacy of the videoscopic procedure.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | University supervisor: and Leeuwen, Dr. B.L. Van and Daily supervisor: and Vrielink, drs. O.M. and Department of Surgical Oncology and University Medical Center Groningen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/772 |
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