Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 1998 Mar;133(3):272-4; discussion 275.
doi: 10.1001/archsurg.133.3.272.

Extraperitoneal laparoscopically assisted ilioinguinal lymphadenectomy for treatment of malignant melanoma

M Trias  1 , E M Targarona, J Piulachs, C Balagué, E Bombuy, J J Espert, A Moral, M T Castel
Affiliations
Comparative Study

Extraperitoneal laparoscopically assisted ilioinguinal lymphadenectomy for treatment of malignant melanoma

M Trias et al. Arch Surg. 1998 Mar.

Abstract

Background: Current treatment of malignant melanoma of the leg includes ilioinguinal lymphadenectomy (IIL). Standard open IIL (open IIL) includes sectioning of the inguinal ligament to gain access to the iliac nodes. Extraperitoneal laparoscopic IIL (lap IIL) is a feasible, less aggressive approach. It can be combined with standard superficial lymphadenectomy for treatment of malignant melanoma.

Design: Comparative, prospective, nonrandomized series.

Setting: Tertiary care center.

Patients: Twelve consecutive, unselected patients with malignant melanoma treated with lap IIL (group 1) were compared with 10 consecutive, unselected patients with malignant melanoma on whom open IIL was performed (group 2).

Interventions: Standard open IIL and laparoscopic extraperitoneal iliac lymphadenectomy (lap IIL) plus superficial groin lymphadenectomy.

Main outcome measures: Operative time, intraoperative complications, requirements of analgesia, total volume of lymphatic drainage, number of lymph nodes retrieved, immediate morbidity, hospital stay, and long-term morbidity were evaluated.

Results: Operative time was significantly longer for the lap IIL group (group 1) than for the open IIL group (group 2) (177+/-44 vs 140+/-18 minutes, respectively; P<.05), but no patients in group 1 needed conversion to open surgery or developed related complications. Overall lymphatic drainage was significantly lower in group 1 than in group 2 (615+/-518 mL vs 1393+/-793 mL, repectively; P<.01). The number of doses of analgesics (13+/-8 vs 31+/-22, P<.03) and length of postoperative stay (7.3+/-3.3 vs 13+/-5 days, P<.006) were also significantly lower in the laparoscopic group. The overall number of lymph nodes retrieved was similar in both groups (10.2+/-4.6 vs 10+/-3, P=.9). One patient developed a groin hernia of 6 m after open IIL.

Conclusions: Laparoscopically assisted IIL offers a less aggressive approach than open IIL and entails less pain and a shorter hospital stay, as we observed in 2 groups with similar oncological results (mainly, a similar number of lymph nodes retrieved) who were treated with one procedure or the other. Further research should be done to confirm these preliminary advantages in a prospective randomized trial with long-term follow-up.

PubMed Disclaimer

Publication types