Predictors of Complications after Inguinal Lymphadenectomy
Identifieur interne : 000C46 ( Istex/Corpus ); précédent : 000C45; suivant : 000C47Predictors of Complications after Inguinal Lymphadenectomy
Auteurs : Natalie Gould ; Scott Kamelle ; Todd Tillmanns ; Dennis Scribner ; Michael Gold ; Joan Walker ; Robert MannelSource :
- Gynecologic Oncology [ 0090-8258 ] ; 2001.
English descriptors
- KwdEn :
Abstract
Objective. The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma. Methods. Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ2 and t tests. Results. Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (<30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (P = <0.001, RR 14.2) or early lymphocyst formation (P = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications. Conclusions. Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.
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DOI: 10.1006/gyno.2001.6266
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73190</mods:affiliation></affiliation></author><author><name sortKey="Tillmanns, Todd" sort="Tillmanns, Todd" uniqKey="Tillmanns T" first="Todd" last="Tillmanns">Todd Tillmanns</name><affiliation><mods:affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</mods:affiliation></affiliation></author><author><name sortKey="Scribner, Dennis" sort="Scribner, Dennis" uniqKey="Scribner D" first="Dennis" last="Scribner">Dennis Scribner</name><affiliation><mods:affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</mods:affiliation></affiliation></author><author><name sortKey="Gold, Michael" sort="Gold, Michael" uniqKey="Gold M" first="Michael" last="Gold">Michael Gold</name><affiliation><mods:affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</mods:affiliation></affiliation></author><author><name sortKey="Walker, Joan" sort="Walker, Joan" uniqKey="Walker J" first="Joan" last="Walker">Joan Walker</name><affiliation><mods:affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</mods:affiliation></affiliation></author><author><name sortKey="Mannel, Robert" sort="Mannel, Robert" uniqKey="Mannel R" first="Robert" last="Mannel">Robert Mannel</name><affiliation><mods:affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="ISSN">0090-8258</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001">2001</date><biblScope unit="volume">82</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="329">329</biblScope><biblScope unit="page" to="332">332</biblScope></imprint><idno type="ISSN">0090-8258</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0090-8258</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>complications</term><term>lymphadenectomy</term><term>lymphedema</term><term>vulvar cancer</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective. The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma. Methods. Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ2 and t tests. Results. Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (<30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (P = <0.001, RR 14.2) or early lymphocyst formation (P = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications. Conclusions. Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.</div></front></TEI><istex><corpusName>elsevier</corpusName><keywords><teeft><json:string>lymphedema</json:string><json:string>cellulitis</json:string><json:string>lymphadenectomy</json:string><json:string>postoperative</json:string><json:string>inguinal</json:string><json:string>prophylactic</json:string><json:string>node</json:string><json:string>vulvar</json:string><json:string>suction drainage</json:string><json:string>lymphocyst</json:string><json:string>gynecol</json:string><json:string>inguinal lymphadenectomy</json:string><json:string>early wound breakdown</json:string><json:string>vulva</json:string><json:string>adjuvant</json:string><json:string>chronic lymphedema</json:string><json:string>antibiotic</json:string><json:string>suction</json:string><json:string>early complications</json:string><json:string>saphenous</json:string><json:string>late lymphedema</json:string><json:string>adjuvant therapy</json:string><json:string>oncol</json:string><json:string>early cellulitis</json:string><json:string>lymphocysts</json:string><json:string>incision</json:string><json:string>morbidity</json:string><json:string>gynecologic</json:string><json:string>obstet</json:string><json:string>obstet gynecol</json:string><json:string>gynecol oncol</json:string><json:string>early lymphocyst formation</json:string><json:string>late cellulitis</json:string><json:string>radical vulvar surgery</json:string><json:string>postoperative prophylactic antibiotics</json:string><json:string>oncology</json:string><json:string>invasive</json:string><json:string>early lymphedema</json:string><json:string>postoperative prophylactic antibiotic</json:string><json:string>saphenous vein</json:string><json:string>predictor</json:string><json:string>carcinoma</json:string><json:string>late wound breakdown</json:string><json:string>wound breakdown</json:string><json:string>debilitating consequence</json:string><json:string>prophylactic antibiotics</json:string><json:string>suction drains</json:string><json:string>late complications</json:string><json:string>oklahoma health sciences center</json:string><json:string>vulvar cancer</json:string><json:string>separate groin incisions</json:string><json:string>complication</json:string></teeft></keywords><author><json:item><name>Natalie Gould M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Scott Kamelle M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Todd Tillmanns M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Dennis Scribner M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Michael Gold M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Joan Walker M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item><json:item><name>Robert Mannel M.D.</name><affiliations><json:string>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>vulvar cancer</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lymphadenectomy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>complications</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>lymphedema</value></json:item></subject><language><json:string>eng</json:string></language><originalGenre><json:string>Full-length article</json:string></originalGenre><abstract>Objective. The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma. Methods. Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ2 and t tests. Results. Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (>30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (P = >0.001, RR 14.2) or early lymphocyst formation (P = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications. Conclusions. Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.</abstract><qualityIndicators><score>5.156</score><pdfVersion>1.3</pdfVersion><pdfPageSize>545 x 738 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1783</abstractCharCount><pdfWordCount>2156</pdfWordCount><pdfCharCount>13858</pdfCharCount><pdfPageCount>4</pdfPageCount><abstractWordCount>261</abstractWordCount></qualityIndicators><title>Predictors of Complications after Inguinal Lymphadenectomy</title><pii><json:string>S0090-8258(01)96266-3</json:string></pii><genre><json:string>research-article</json:string></genre><host><title>Gynecologic Oncology</title><language><json:string>unknown</json:string></language><publicationDate>2001</publicationDate><issn><json:string>0090-8258</json:string></issn><pii><json:string>S0090-8258(00)X0007-8</json:string></pii><volume>82</volume><issue>2</issue><pages><first>329</first><last>332</last></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>oncology</json:string><json:string>obstetrics & gynecology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>oncology & carcinogenesis</json:string></scienceMetrix><inist><json:string>sciences appliquees, technologies et medecines</json:string><json:string>sciences biologiques et medicales</json:string><json:string>sciences medicales</json:string><json:string>gynecologie. andrologie. obstetrique</json:string></inist></categories><publicationDate>2001</publicationDate><copyrightDate>2001</copyrightDate><doi><json:string>10.1006/gyno.2001.6266</json:string></doi><id>1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Predictors of Complications after Inguinal Lymphadenectomy</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>©2001 Academic Press</p></availability><date>2001</date></publicationStmt><notesStmt><note type="content">Section title: Regular Article</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Predictors of Complications after Inguinal Lymphadenectomy</title><author xml:id="author-0000"><persName><forename type="first">Natalie</forename><surname>Gould</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Scott</forename><surname>Kamelle</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Todd</forename><surname>Tillmanns</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Dennis</forename><surname>Scribner</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Michael</forename><surname>Gold</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0005"><persName><forename type="first">Joan</forename><surname>Walker</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><author xml:id="author-0006"><persName><forename type="first">Robert</forename><surname>Mannel</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation></author><idno type="istex">1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F</idno><idno type="DOI">10.1006/gyno.2001.6266</idno><idno type="PII">S0090-8258(01)96266-3</idno></analytic><monogr><title level="j">Gynecologic Oncology</title><title level="j" type="abbrev">YGYNO</title><idno type="pISSN">0090-8258</idno><idno type="PII">S0090-8258(00)X0007-8</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="2001"></date><biblScope unit="volume">82</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="329">329</biblScope><biblScope unit="page" to="332">332</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2001</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Objective. The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma. Methods. Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ2 and t tests. Results. Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (<30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (P = <0.001, RR 14.2) or early lymphocyst formation (P = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications. Conclusions. Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>vulvar cancer</term></item><item><term>lymphadenectomy</term></item><item><term>complications</term></item><item><term>lymphedema</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2001">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>YGYNO</jid><aid>96266</aid><ce:pii>S0090-8258(01)96266-3</ce:pii><ce:doi>10.1006/gyno.2001.6266</ce:doi><ce:copyright type="full-transfer" year="2001">Academic Press</ce:copyright></item-info><head><ce:dochead><ce:textfn>Regular Article</ce:textfn></ce:dochead><ce:title>Predictors of Complications after Inguinal Lymphadenectomy</ce:title><ce:author-group><ce:author><ce:given-name>Natalie</ce:given-name><ce:surname>Gould</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Scott</ce:given-name><ce:surname>Kamelle</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Todd</ce:given-name><ce:surname>Tillmanns</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Dennis</ce:given-name><ce:surname>Scribner</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Michael</ce:given-name><ce:surname>Gold</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Joan</ce:given-name><ce:surname>Walker</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:author><ce:given-name>Robert</ce:given-name><ce:surname>Mannel</ce:surname><ce:degrees>M.D.</ce:degrees></ce:author><ce:affiliation><ce:textfn>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</ce:textfn></ce:affiliation></ce:author-group><ce:date-received day="13" month="11" year="2000"></ce:date-received><ce:abstract><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para><ce:italic>Objective.</ce:italic> The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma.</ce:simple-para><ce:simple-para><ce:italic>Methods.</ce:italic> Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ<ce:sup>2</ce:sup> and <ce:italic>t</ce:italic> tests.</ce:simple-para><ce:simple-para><ce:italic>Results.</ce:italic> Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (<30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (<ce:italic>P</ce:italic> = <0.001, RR 14.2) or early lymphocyst formation (<ce:italic>P</ce:italic> = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications.</ce:simple-para><ce:simple-para><ce:italic>Conclusions.</ce:italic> Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.</ce:simple-para></ce:abstract-sec></ce:abstract><ce:keywords><ce:section-title>Keywords</ce:section-title><ce:keyword><ce:text>vulvar cancer</ce:text></ce:keyword><ce:keyword><ce:text>lymphadenectomy</ce:text></ce:keyword><ce:keyword><ce:text>complications</ce:text></ce:keyword><ce:keyword><ce:text>lymphedema</ce:text></ce:keyword></ce:keywords></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Predictors of Complications after Inguinal Lymphadenectomy</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Predictors of Complications after Inguinal Lymphadenectomy</title></titleInfo><name type="personal"><namePart type="given">Natalie</namePart><namePart type="family">Gould</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Scott</namePart><namePart type="family">Kamelle</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Todd</namePart><namePart type="family">Tillmanns</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dennis</namePart><namePart type="family">Scribner</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michael</namePart><namePart type="family">Gold</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joan</namePart><namePart type="family">Walker</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert</namePart><namePart type="family">Mannel</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, 73190</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">2001</dateIssued><copyrightDate encoding="w3cdtf">2001</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Objective. The aim of this study was to identify predictors of complications in patients undergoing inguinal lymphadenectomy (LND) in the treatment of vulvar carcinoma. Methods. Clinical information was abstracted from records of patients with invasive vulvar cancer. All patients underwent LND. Closed suction drains were placed in groin incisions and removed when output was less than 30 ml/24 h. Associations between variables were studied by χ2 and t tests. Results. Sixty-seven patients undergoing 112 LND were evaluated. Eighty-eight percent of patients underwent radical vulvar surgery and LND while 12% underwent LND alone. Patients were treated with either unilateral (22) or bilateral (45) LND. Seventy-three percent received extended postoperative prophylactic antibiotics. The median duration of suction drainage was 15 days for one drain and 14 days for two drains. Early postoperative cellulitis (<30 days after surgery) developed in 35.4%, early wound breakdown in 19.4%, early lymphedema in 4.8%, and early lymphocyst formation in 13.1%. Late cellulitis (>30 days after surgery) developed in 22.2%, late wound breakdown in 3.2%, late lymphedema in 29.5%, and late lymphocysts in 5%. Patients developing early cellulitis were more likely to have early wound breakdown (P = <0.001, RR 14.2) or early lymphocyst formation (P = 0.016, RR 7.6). Type of procedure, antibiotic use, need for adjuvant therapy, and duration of suction drainage did not influence early complications. Early complications and management strategies did not predict late complications. Conclusions. Chronic lymphedema occurs in nearly 30% of patients after LND. Late complications after LND were not predicted by early complications. New strategies for prevention of chronic lymphedema are needed.</abstract><note type="content">Section title: Regular Article</note><subject lang="en"><genre>Keywords</genre><topic>vulvar cancer</topic><topic>lymphadenectomy</topic><topic>complications</topic><topic>lymphedema</topic></subject><relatedItem type="host"><titleInfo><title>Gynecologic Oncology</title></titleInfo><titleInfo type="abbreviated"><title>YGYNO</title></titleInfo><genre type="journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">200108</dateIssued></originInfo><identifier type="ISSN">0090-8258</identifier><identifier type="PII">S0090-8258(00)X0007-8</identifier><part><date>200108</date><detail type="volume"><number>82</number><caption>vol.</caption></detail><detail type="issue"><number>2</number><caption>no.</caption></detail><extent unit="issue pages"><start>221</start><end>412</end></extent><extent unit="pages"><start>329</start><end>332</end></extent></part></relatedItem><identifier type="istex">1AB03F3FD9C9BD5A1254BC4C83419C927EDC4A7F</identifier><identifier type="DOI">10.1006/gyno.2001.6266</identifier><identifier type="PII">S0090-8258(01)96266-3</identifier><accessCondition type="use and reproduction" contentType="copyright">©2001 Academic Press</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Academic Press, ©2001</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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