Annales de dermatologie et de venereologie · 2013
[Complication of radical lymph node dissection following sentinel lymph node biopsy in patients with melanoma].
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Litrowski N, Duval Modeste A-B, Coquerel D, Courville P, Milliez P-Y, Joly P
Аннотация
OBJECTIVE: To assess the rate of complications of radical lymph node dissection following sentinel lymph node biopsy in patients with malignant melanoma.
PATIENTS AND METHODS: A single-centre retrospective study was performed between 2001 and 2009. All melanoma patients who first had a sentinel node biopsy followed by a radical lymph node dissection were included.
RESULTS: Seventy-four patients had radical lymph node dissection after confirmation of metastasis in a sentinel node. The sites of the lymphadenectomy were axillary in 51% of patients, groin in 43%, neck in 5% and popliteal in 1%. A nodal metastasis was observed in 12 of 74 lymph node dissections. Median follow-up time was 41.5 months (3-135 months). At least one complication was seen in 47 patients (64%). Early complications were: postoperative infection (n=9; 12%), lymphocele (n=22; 30%), chronic seroma (n=9; 12%), postoperative haematoma (n=6; 8%), and wound separation (n=7; 9%). Late complications were: lymphoedema (n=30; 41%), joint complications (n=10; 14%), fibrous scar (n=11; 15%), chronic pain (n=6; 8%) and hyposensitivity (n=6; 8%). Two patients were rehospitalised for a complication. The complication rate was 53% for axillary location and 81% for inguinal location (P=0.02).
CONCLUSION: Radical lymph node dissection performed after positive sentinel node biopsy in melanoma patients is associated with significant morbidity.
PATIENTS AND METHODS: A single-centre retrospective study was performed between 2001 and 2009. All melanoma patients who first had a sentinel node biopsy followed by a radical lymph node dissection were included.
RESULTS: Seventy-four patients had radical lymph node dissection after confirmation of metastasis in a sentinel node. The sites of the lymphadenectomy were axillary in 51% of patients, groin in 43%, neck in 5% and popliteal in 1%. A nodal metastasis was observed in 12 of 74 lymph node dissections. Median follow-up time was 41.5 months (3-135 months). At least one complication was seen in 47 patients (64%). Early complications were: postoperative infection (n=9; 12%), lymphocele (n=22; 30%), chronic seroma (n=9; 12%), postoperative haematoma (n=6; 8%), and wound separation (n=7; 9%). Late complications were: lymphoedema (n=30; 41%), joint complications (n=10; 14%), fibrous scar (n=11; 15%), chronic pain (n=6; 8%) and hyposensitivity (n=6; 8%). Two patients were rehospitalised for a complication. The complication rate was 53% for axillary location and 81% for inguinal location (P=0.02).
CONCLUSION: Radical lymph node dissection performed after positive sentinel node biopsy in melanoma patients is associated with significant morbidity.
Предметные рубрики MeSH
AdultAgedCicatrixFalse Positive ReactionsFemaleFollow-Up StudiesHumansLymph Node ExcisionLymphatic MetastasisLymphedemaLymphoceleMaleMelanomaMiddle AgedNeck DissectionPainPatient ReadmissionPostoperative ComplicationsPostoperative HemorrhageRetrospective StudiesSensation DisordersSentinel Lymph Node BiopsySurgical Wound DehiscenceSurgical Wound InfectionYoung Adult