Inguinal Lymphadenectomy For Stage Iii Melanoma: A Comparative Study Of Two Surgical Approaches At The Onset Of Lymphoedema
Identifieur interne : 000002 ( Hal/Checkpoint ); précédent : 000001; suivant : 000003Inguinal Lymphadenectomy For Stage Iii Melanoma: A Comparative Study Of Two Surgical Approaches At The Onset Of Lymphoedema
Auteurs : Nicolas Bertheuil [France] ; Laurent Sulpice [France] ; Giovanni Battista Levi Sandri [France] ; Vincent Lavoué [France] ; Eric Watier [France] ; Bernard Meunier [France]Source :
- EJSO - European Journal of Surgical Oncology [ 0748-7983 ] ; 2014-12-09.
Descripteurs français
- Wicri :
- topic : Chirurgie.
English descriptors
Abstract
Introduction: When sentinel lymph node is positive for metastasis (exclusion for micro-metastasis) and in cases of palpable adenopathy, a lymphadenectomy should be performed. Many incisional surgical approach have been described in literature. We perform two type of incision (vertical with skin excision and transversal) for inguinal lymphadenectomy. The aim of this study was to compare post-operative morbidity between these two approach in cases of Stage III Melanoma. We analyzed chronic lymphoedeme, skin necrosis, wound dehiscence, wound infection and seroma rates between the two techniques.-three patients underwent to inguinal lymphadenectomy for Stage III melanoma at CHU of Rennes. Patients were stratified in 2 groups according to the surgical approach, group 1 with a vertical incision with skin excision and group 2 with a transverse incision. Results: Chronic lymphedema rate for group 1 was 37.04% and for group 2 rate was 26.92%, this complication was lower un group 2 but no significant difference was observed (p=0.558). Skin necrosis (p=0.235), wound dehiscence (p=1.000), wound infection (p=0.236) and seroma (p=0.757) were not significantly different. Two cases of skin necrosis were observed in group 2 (7.69%) and none in group 1. Conclusion: We do not found significant difference for chronic lymphedema between these two approach. However, we had less lymphedema with the transversal technique which has the advantage to reduce the skin suffering when external iliac lymphadenectomy dissection is necessary in addition to the inguinal lymphadenectomy.
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DOI: 10.1016/j.ejso.2014.10.062
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Toulouse 3</orgName> <orgName type="acronym">UPS</orgName> <desc> <address> <addrLine>118 route de Narbonne - 31062 Toulouse</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.univ-tlse3.fr/</ref> </desc></org></tutelle><tutelle active="#struct-300164" type="direct"><org type="institution" xml:id="struct-300164" status="VALID"> <orgName>EFS</orgName> <desc> <address> <country key="FR"></country> </address> </desc></org></tutelle><tutelle name="U1031" active="#struct-303623" type="direct"><org type="institution" xml:id="struct-303623" status="VALID"> <idno type="IdRef">026388278</idno> <orgName>Institut National de la Santé et de la Recherche Médicale</orgName> <orgName type="acronym">INSERM</orgName> <desc> <address> <addrLine>101, rue de Tolbiac, 75013 Paris </addrLine> <country key="FR"></country> </address> <ref type="url">http://www.inserm.fr</ref> </desc></org></tutelle><tutelle name="UMR5273" active="#struct-441569" type="direct"><org type="institution" xml:id="struct-441569" status="VALID"> <idno type="ISNI">0000000122597504</idno> <idno type="IdRef">02636817X</idno> <orgName>Centre National de la Recherche Scientifique</orgName> <orgName type="acronym">CNRS</orgName> <date type="start">1939-10-19</date> <desc> <address> <country key="FR"></country> </address> <ref type="url">http://www.cnrs.fr/</ref> </desc></org></tutelle></tutelles></hal:affiliation><country>France</country></affiliation></author><author><name sortKey="Sulpice, Laurent" sort="Sulpice, Laurent" uniqKey="Sulpice L" first="Laurent" last="Sulpice">Laurent Sulpice</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-105755" status="INCOMING"> <orgName>Service de Chirurgie Hépatobiliaire et Digestive</orgName> <desc> <address> <addrLine>2 Rue Henri le Guilloux, 35000 Rennes</addrLine> <country key="FR"></country> </address> </desc> <listRelation> <relation active="#struct-105160" type="direct"></relation> <relation active="#struct-300129" type="direct"></relation> <relation active="#struct-301327" type="direct"></relation> </listRelation><tutelles><tutelle active="#struct-105160" type="direct"><org type="institution" xml:id="struct-105160" status="VALID"> <orgName>Université de Rennes 1</orgName> <orgName type="acronym">UR1</orgName> <desc> <address> <addrLine>2 rue du Thabor - CS 46510 - 35065 Rennes cedex</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.univ-rennes1.fr/</ref> </desc></org></tutelle><tutelle active="#struct-300129" type="direct"><org type="institution" xml:id="struct-300129" status="VALID"> <orgName>Hôpital Pontchaillou</orgName> <desc> <address> <country key="FR"></country> </address> </desc></org></tutelle><tutelle active="#struct-301327" type="direct"><org type="institution" xml:id="struct-301327" status="VALID"> <orgName>CHU Pontchaillou [Rennes]</orgName> <desc> <address> <addrLine>2 Rue Henri le Guilloux, 35000 Rennes</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.chu-rennes.fr/</ref> </desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Rennes</settlement><region type="region" nuts="2">Région Bretagne</region></placeName><orgName type="university">Université de Rennes 1</orgName><orgName type="institution" wicri:auto="newGroup">Université européenne de Bretagne</orgName></affiliation></author><author><name sortKey="Levi Sandri, Giovanni Battista" sort="Levi Sandri, Giovanni Battista" uniqKey="Levi Sandri G" first="Giovanni Battista" last="Levi Sandri">Giovanni Battista Levi Sandri</name><affiliation wicri:level="1"><hal:affiliation type="laboratory" xml:id="struct-105755" status="INCOMING"> <orgName>Service de Chirurgie Hépatobiliaire et Digestive</orgName> <desc> <address> <addrLine>2 Rue Henri le Guilloux, 35000 Rennes</addrLine> <country key="FR"></country> </address> </desc> <listRelation> <relation active="#struct-105160" type="direct"></relation> <relation active="#struct-300129" type="direct"></relation> <relation active="#struct-301327" type="direct"></relation> </listRelation><tutelles><tutelle active="#struct-105160" type="direct"><org type="institution" xml:id="struct-105160" status="VALID"> <orgName>Université de Rennes 1</orgName> <orgName type="acronym">UR1</orgName> <desc> <address> <addrLine>2 rue du Thabor - 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CS 46510 - 35065 Rennes cedex</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.univ-rennes1.fr/</ref> </desc></org></tutelle><tutelle active="#struct-300129" type="direct"><org type="institution" xml:id="struct-300129" status="VALID"> <orgName>Hôpital Pontchaillou</orgName> <desc> <address> <country key="FR"></country> </address> </desc></org></tutelle><tutelle active="#struct-301327" type="direct"><org type="institution" xml:id="struct-301327" status="VALID"> <orgName>CHU Pontchaillou [Rennes]</orgName> <desc> <address> <addrLine>2 Rue Henri le Guilloux, 35000 Rennes</addrLine> <country key="FR"></country> </address> <ref type="url">http://www.chu-rennes.fr/</ref> </desc></org></tutelle></tutelles></hal:affiliation><country>France</country><placeName><settlement type="city">Rennes</settlement><region type="region" nuts="2">Région Bretagne</region></placeName><orgName type="university">Université de Rennes 1</orgName><orgName type="institution" wicri:auto="newGroup">Université européenne de Bretagne</orgName></affiliation></author></analytic><idno type="DOI">10.1016/j.ejso.2014.10.062</idno><series><title level="j">EJSO - European Journal of Surgical Oncology</title><idno type="ISSN">0748-7983</idno><imprint><date type="datePub">2014-12-09</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="mix" xml:lang="en"><term>Inguinal lymphadenectomy</term><term>Lymphoedema</term><term>Stage III melanoma</term><term>Surgery</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Introduction: When sentinel lymph node is positive for metastasis (exclusion for micro-metastasis) and in cases of palpable adenopathy, a lymphadenectomy should be performed. Many incisional surgical approach have been described in literature. We perform two type of incision (vertical with skin excision and transversal) for inguinal lymphadenectomy. The aim of this study was to compare post-operative morbidity between these two approach in cases of Stage III Melanoma. We analyzed chronic lymphoedeme, skin necrosis, wound dehiscence, wound infection and seroma rates between the two techniques.-three patients underwent to inguinal lymphadenectomy for Stage III melanoma at CHU of Rennes. Patients were stratified in 2 groups according to the surgical approach, group 1 with a vertical incision with skin excision and group 2 with a transverse incision. Results: Chronic lymphedema rate for group 1 was 37.04% and for group 2 rate was 26.92%, this complication was lower un group 2 but no significant difference was observed (p=0.558). Skin necrosis (p=0.235), wound dehiscence (p=1.000), wound infection (p=0.236) and seroma (p=0.757) were not significantly different. Two cases of skin necrosis were observed in group 2 (7.69%) and none in group 1. Conclusion: We do not found significant difference for chronic lymphedema between these two approach. However, we had less lymphedema with the transversal technique which has the advantage to reduce the skin suffering when external iliac lymphadenectomy dissection is necessary in addition to the inguinal lymphadenectomy.</div></front></TEI><hal api="V3"> <titleStmt> <title xml:lang="en">Inguinal Lymphadenectomy For Stage Iii Melanoma: A Comparative Study Of Two Surgical Approaches At The Onset Of Lymphoedema</title> <author role="aut"> <persName> <forename type="first">Nicolas</forename> <surname>Bertheuil</surname> </persName> <email type="md5">600c032a3edaf3be041734ecb673b7d0</email> <email type="domain">gmail.com</email> <idno type="halauthorid">902638</idno> <affiliation ref="#struct-139722"></affiliation> <affiliation ref="#struct-175429"></affiliation> <affiliation ref="#struct-300164"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Laurent</forename> <surname>Sulpice</surname> </persName> <email type="md5">53f0d8ac561c224eec8e561a208768f2</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">890212</idno> <affiliation ref="#struct-105755"></affiliation> </author> <author role="crp"> <persName> <forename type="first">Giovanni Battista</forename> <surname>Levi Sandri</surname> </persName> <email type="md5">b0f72f7a61de142ddcf7bd2b5279470a</email> <email type="domain">gmail.com</email> <idno type="halauthorid">1116258</idno> <affiliation ref="#struct-105755"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Vincent</forename> <forename type="middle">Vincent.Lavoue@chu-Rennes.Fr</forename> <surname>Lavoué</surname> </persName> <email type="md5">b2b1b670aba116b5df1dbcbbf139db59</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">448752</idno> <affiliation ref="#struct-85948"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Eric</forename> <surname>Watier</surname> </persName> <idno type="halauthorid">497511</idno> <affiliation ref="#struct-117349"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Bernard</forename> <surname>Meunier</surname> </persName> <email type="md5">5011b308e68be850b67056aa97d89616</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">632855</idno> <affiliation ref="#struct-105755"></affiliation> </author> <editor role="depositor"> <persName> <forename>Marie</forename> <surname>Lecoupe-Grainville</surname> </persName> <email type="md5">484b6031ecb6dada35f8b852cb037068</email> <email type="domain">univ-rennes1.fr</email> </editor> </titleStmt> <editionStmt> <edition n="v1" type="current"> <date type="whenSubmitted">2015-01-14 16:05:14</date> <date type="whenModified">2016-10-20 14:47:06</date> <date type="whenReleased">2015-01-14 16:13:10</date> <date type="whenProduced">2014-12-09</date> <date type="whenEndEmbargoed">2015-01-14</date> <ref type="file" target="https://hal-univ-rennes1.archives-ouvertes.fr/hal-01103387/document"> <date notBefore="2015-01-14"></date> </ref> <ref type="file" subtype="author" n="1" target="https://hal-univ-rennes1.archives-ouvertes.fr/hal-01103387/file/Inguinal%20Lymphadenectomy_accepted.pdf"> <date notBefore="2015-01-14"></date> </ref> </edition> <respStmt> <resp>contributor</resp> <name key="182812"> <persName> <forename>Marie</forename> <surname>Lecoupe-Grainville</surname> </persName> <email type="md5">484b6031ecb6dada35f8b852cb037068</email> <email type="domain">univ-rennes1.fr</email> </name> </respStmt> </editionStmt> <publicationStmt> <distributor>CCSD</distributor> <idno type="halId">hal-01103387</idno> <idno type="halUri">https://hal-univ-rennes1.archives-ouvertes.fr/hal-01103387</idno> <idno type="halBibtex">bertheuil:hal-01103387</idno> <idno type="halRefHtml">EJSO - European Journal of Surgical Oncology, WB Saunders, 2014, in press. <10.1016/j.ejso.2014.10.062></idno> <idno type="halRef">EJSO - European Journal of Surgical Oncology, WB Saunders, 2014, in press. <10.1016/j.ejso.2014.10.062></idno> </publicationStmt> <seriesStmt> <idno type="stamp" n="UNIV-RENNES1">Université de Rennes 1</idno> <idno type="stamp" n="CNRS">CNRS - Centre national de la recherche scientifique</idno> <idno type="stamp" n="HL">Publications CHU - Rennes 1</idno> <idno type="stamp" n="INSERM">INSERM - Institut national de la santé et de la recherche médicale</idno> <idno type="stamp" n="UNIV-TLSE3">Université Paul Sabatier - Toulouse III</idno> <idno type="stamp" n="STATS-UR1">Statistiques-HAL-UR1</idno> <idno type="stamp" n="UR1-HAL">Publications labos UR1 dans HAL-Rennes 1</idno> <idno type="stamp" n="UR1-SDV">UR1 - publications SDV</idno> </seriesStmt> <notesStmt> <note type="audience" n="2">International</note> <note type="popular" n="0">No</note> <note type="peer" n="1">Yes</note> </notesStmt> <sourceDesc> <biblStruct> <analytic> <title xml:lang="en">Inguinal Lymphadenectomy For Stage Iii Melanoma: A Comparative Study Of Two Surgical Approaches At The Onset Of Lymphoedema</title> <author role="aut"> <persName> <forename type="first">Nicolas</forename> <surname>Bertheuil</surname> </persName> <email type="md5">600c032a3edaf3be041734ecb673b7d0</email> <email type="domain">gmail.com</email> <idno type="halauthorid">902638</idno> <affiliation ref="#struct-139722"></affiliation> <affiliation ref="#struct-175429"></affiliation> <affiliation ref="#struct-300164"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Laurent</forename> <surname>Sulpice</surname> </persName> <email type="md5">53f0d8ac561c224eec8e561a208768f2</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">890212</idno> <affiliation ref="#struct-105755"></affiliation> </author> <author role="crp"> <persName> <forename type="first">Giovanni Battista</forename> <surname>Levi Sandri</surname> </persName> <email type="md5">b0f72f7a61de142ddcf7bd2b5279470a</email> <email type="domain">gmail.com</email> <idno type="halauthorid">1116258</idno> <affiliation ref="#struct-105755"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Vincent</forename> <forename type="middle">Vincent.Lavoue@chu-Rennes.Fr</forename> <surname>Lavoué</surname> </persName> <email type="md5">b2b1b670aba116b5df1dbcbbf139db59</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">448752</idno> <affiliation ref="#struct-85948"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Eric</forename> <surname>Watier</surname> </persName> <idno type="halauthorid">497511</idno> <affiliation ref="#struct-117349"></affiliation> </author> <author role="aut"> <persName> <forename type="first">Bernard</forename> <surname>Meunier</surname> </persName> <email type="md5">5011b308e68be850b67056aa97d89616</email> <email type="domain">chu-rennes.fr</email> <idno type="halauthorid">632855</idno> <affiliation ref="#struct-105755"></affiliation> </author> </analytic> <monogr> <idno type="halJournalId" status="VALID">13104</idno> <idno type="issn">0748-7983</idno> <title level="j">EJSO - European Journal of Surgical Oncology</title> <imprint> <publisher>WB Saunders</publisher> <biblScope unit="pp">in press</biblScope> <date type="datePub">2014-12-09</date> </imprint> </monogr> <idno type="doi">10.1016/j.ejso.2014.10.062</idno> <idno type="pubmed">25524886</idno> </biblStruct> </sourceDesc> <profileDesc> <langUsage> <language ident="en">English</language> </langUsage> <textClass> <keywords scheme="author"> <term xml:lang="en">Surgery</term> <term xml:lang="en">Lymphoedema</term> <term xml:lang="en">Stage III melanoma</term> <term xml:lang="en">Inguinal lymphadenectomy</term> </keywords> <classCode scheme="halDomain" n="sdv.mhep.chi">Life Sciences [q-bio]/Human health and pathology/Surgery</classCode> <classCode scheme="halTypology" n="ART">Journal articles</classCode> </textClass> <abstract xml:lang="en">Introduction: When sentinel lymph node is positive for metastasis (exclusion for micro-metastasis) and in cases of palpable adenopathy, a lymphadenectomy should be performed. Many incisional surgical approach have been described in literature. We perform two type of incision (vertical with skin excision and transversal) for inguinal lymphadenectomy. The aim of this study was to compare post-operative morbidity between these two approach in cases of Stage III Melanoma. We analyzed chronic lymphoedeme, skin necrosis, wound dehiscence, wound infection and seroma rates between the two techniques.-three patients underwent to inguinal lymphadenectomy for Stage III melanoma at CHU of Rennes. Patients were stratified in 2 groups according to the surgical approach, group 1 with a vertical incision with skin excision and group 2 with a transverse incision. Results: Chronic lymphedema rate for group 1 was 37.04% and for group 2 rate was 26.92%, this complication was lower un group 2 but no significant difference was observed (p=0.558). Skin necrosis (p=0.235), wound dehiscence (p=1.000), wound infection (p=0.236) and seroma (p=0.757) were not significantly different. Two cases of skin necrosis were observed in group 2 (7.69%) and none in group 1. Conclusion: We do not found significant difference for chronic lymphedema between these two approach. However, we had less lymphedema with the transversal technique which has the advantage to reduce the skin suffering when external iliac lymphadenectomy dissection is necessary in addition to the inguinal lymphadenectomy.</abstract> </profileDesc> </hal></record>Pour manipuler ce document sous Unix (Dilib)
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