Surgical outcomes and morbidity in open and videoendoscopic inguinal lymphadenectomy in vulvar cancer: A systematic review and metanalysis".

IF 3.5 2区医学 Q2 ONCOLOGY Ejso Pub Date : 2024-10-04 DOI:10.1016/j.ejso.2024.108744

Mariano Catello Di Donna, Giuseppe Cucinella, Vincenzo Giallombardo, Giuseppina Lo Balbo, Vito Andrea Capozzi, Giulio Sozzi, Natalina Buono, Letizia Borsellino, Andrea Giannini, Antonio Simone Laganà, Giovanni Scambia, Vito Chiantera

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Abstract

Introduction: Surgical evaluation of inguinal lymph nodes is essential to correctly guide the adjuvant treatment of vulvar cancer patients. Open inguinal lymphadenectomy (OIL) approach is the preferred route, while the videoendoscopic inguinal lymphadenectomy (VEIL) seems to be associated with better results. This meta-analysis aimed to compare the surgical outcomes of OIL vs VEIL in vulvar cancer.

Methods: The meta-analysis was conducted according to the PRISMA guideline. The search string included the following keywords: "(vulvar cancer) AND ((inguinal) OR (femoral)) AND ((lymph node dissection) OR (lymphadenectomy))". Three double-blind researchers independently extracted data.

Results: Seventeen studies were considered eligible for the analysis. Seven studies were included in the OIL group and ten studies in the VEIL group. A total of 372 groins were included in OIL group and 197 groins in VEIL group. 153 groins (41.1 %) in the OIL group and 25 groins (12.6 %) in the VEIL group developed major complications. The analysis of all lymphatic and wound complications showed that VEIL had a lower rate of lymphatic and wound complications. Estimated blood loss (p = 0.4), hospital stay (p = 0.18), time of drainage (p = 0.74), number of lymph node excised (p = 0.74) did not show significant difference between the two approaches.

Conclusions: VEIL route may be a valid alternative to OIL route with no differences in terms of surgical outcomes, except for operative time that is shorter for OIL. Future analysis of randomized controlled trials in this specific patient population are warranted to confirm these results.

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外阴癌开放式和视频内窥镜腹股沟淋巴结切除术的手术效果和发病率：系统回顾和荟萃分析"。

导言：腹股沟淋巴结的手术评估对于正确指导外阴癌患者的辅助治疗至关重要。开放式腹股沟淋巴结切除术（OIL）是首选方法，而视频内镜腹股沟淋巴结切除术（VEIL）似乎效果更好。这项荟萃分析旨在比较OIL与VEIL在外阴癌中的手术效果：荟萃分析根据 PRISMA 指南进行。搜索字符串包括以下关键词"外阴癌）和（（腹股沟）或（股））和（（淋巴结清扫）或（淋巴结切除））"。三名双盲研究人员独立提取数据：有 17 项研究符合分析条件。结果：17 项研究符合分析条件，其中 7 项研究被纳入 OIL 组，10 项研究被纳入 VEIL 组。共有 372 个腹股沟被纳入 OIL 组，197 个腹股沟被纳入 VEIL 组。OIL 组中有 153 个腹股沟（41.1%）出现主要并发症，VEIL 组中有 25 个腹股沟（12.6%）出现主要并发症。对所有淋巴和伤口并发症的分析表明，VEIL 的淋巴和伤口并发症发生率较低。估计失血量（p = 0.4）、住院时间（p = 0.18）、引流时间（p = 0.74）、切除淋巴结数量（p = 0.74）在两种方法之间没有显著差异：结论：VEIL途径可能是OIL途径的有效替代方案，除了OIL途径的手术时间更短外，在手术效果方面没有差异。今后有必要对这一特定患者群体进行随机对照试验分析，以证实这些结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.