Surgical management of metastatic inguinal lymphadenopathy

doi:10.1136/bmj.329.7477.1272

BMJ 2004;329:1272-1276 (27 November), doi:10.1136/bmj.329.7477.1272

Clinical review

Surgical management of metastatic inguinal lymphadenopathy

Marc C Swan, Royal College of Surgeons of England surgical research fellow¹, Dominic Furniss, Wellcome Trust clinical research training fellow¹, Oliver C S Cassell, consultant surgeon¹

¹ Department of Plastic and Reconstructive Surgery, Radcliffe Infirmary, Oxford OX2 6HE

Correspondence to: M C Swan marc.swan@surgery.oxford.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Inguinal lymphadenectomy, or groin dissection, has a key rolein the management of patients with penile, vulval, anal, andcutaneous malignancy. About 500 procedures are performed inthe United Kingdom each year by general, gynaecological, plastic,and urological surgeons. Groin dissection is associated withhigh postoperative morbidity, chiefly related to wound healingand lymphoedema. As the preoperative diagnosis and postoperativecare of these patients may also involve general practitioners,oncologists, dermatologists, and specialist nurses, this reviewis aimed at providing a concise yet comprehensive summary ofthe key aspects of managing inguinal lymph nodes.

Methods

We searched the Cochrane Library and Medline online databases,using the terms "inguinal lymphadenectomy", "groin dissection",and "sentinel lymph node biopsy", combined with "melanoma",or "carcinoma" and either "vulva", "penis", or "anus". We reviewedabstracts and selected relevant articles.

Pathology

Squamous cell carcinoma is the most common tumour of the penis(table 1, accounting for . . . [Full text of this article]

Clinically relevant anatomy

Clinical assessment

Investigations

Prophylactic versus therapeutic inguinal lymphadenectomy

Sentinel lymph node biopsy

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Surgical approach

Postoperative course

Postoperative complications

Conclusions

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