BMJ  2005;330:538-539 (5 March), doi:10.1136/bmj.330.7490.538-b

Letter

Surgical management of metastatic inguinal lymphadenopathy

The term deep inguinal nodes should be abandoned

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

EDITOR—Swan et al present an interesting review,¹ but their technical recommendations are inconsistent with our experience of groin dissection over 20 years. Evidence for preferential use of straight oblique incisions is minimal.

Tonouchi et al studied only 25 procedures, with eight S-shaped incisions and 17 "straight obliques."² The learning curve and lack of information on the case mix make it difficult to draw conclusions. Our 95 groin dissections using a "lazy S" incision caused one case of wound ischaemia, one case of wound dehiscence, and five postoperative infections. These results compare favourably with studies in which straight oblique incisions were used. An appropriately placed lazy S incision allows excellent access to the apex of the femoral triangle without compromising healing.

Swan et al say that preservation of the long saphenous vein reduces lymphoedema. Zhang et al showed reduced complications in such patients.³ However, a 70% incidence of lymphoedema . . . [Full text of this article]

simoncgibson@hotmail.com, Department of General and Vascular Surgery, Gartnavel General Hospital, Glasgow G12 OYN

Department of General and Vascular Surgery, Gartnavel General Hospital, Glasgow G12 OYN

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Surgical management of metastatic inguinal lymphadenopathy

Marc C Swan, Dominic Furniss, and Oliver C S Cassell
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