Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer?

Jennifer Pontre, Julia Harding, Paola Chivers, Leah Loughlin, Yee Leung, Stuart Salfinger, Jason Tan, Raj Kader Ali Mohan, Paul Cohen

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: Sentinel lymph node biopsy has been widely adopted in the surgical management of women with early-stage vulvar cancer, but many patients require inguinofemoral lymphadenectomy (IFL). Following IFL, many surgeons drain the groin to prevent lymphocyst formation despite a lack of evidence to support this practice. Our objective was to investigate whether groin drains after IFL are associated with reduced postoperative morbidity in women undergoing surgery for vulvar cancer.
METHODS:
A retrospective cohort study of women diagnosed as having primary vulvar cancer who underwent vulvectomy/radical local excision and unilateral or bilateral IFL was conducted. Cases were ascertained from the weekly outcome reports of a statewide tertiary gynecologic oncology tumor board. Data including postoperative outcomes were abstracted from medical records. Patients were stratified into 1 of 2 groups according to whether a groin drain had been used.
RESULTS:
Seventy-one patients were included. Inguinal drains were used in 48 patients (67.6%) and 23 patients (32.4%) did not have their groin wound(s) drained. The most common postoperative complications recorded were wound infection (59.2%), groin lymphocyst (32.4%), and cellulitis (25.4%). The mean length of hospital admission was 11.5 days (2-40 days). Compared with patients in whom inguinal drains were placed, those in the "no drain" group had a significantly lower incidence of postoperative groin cellulitis (8.7% vs 25.4% P = 0.039). No significant differences were observed between patients in the "drain" and "no drain" groups in lymphocyst formation, wound infection, return to the operating room, duration of hospital stay, readmission post-discharge, and lower-limb lymphedema.
CONCLUSIONS:
In this study of patients undergoing inguinofemoral dissection for primary vulvar cancer, postoperative cellulitis occurred less frequently in patients without an inguinal drain. The incidence of other postoperative complications was no different whether or not a groin drain was used. Prospective studies may be warranted.
Original languageEnglish
Pages (from-to)183-187
JournalInternational Journal of Gynecological Cancer
Volume28
Issue number1
DOIs
Publication statusPublished - Jan 2018

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Vulvar Neoplasms
Groin
Lymph Node Excision
Morbidity
Cellulitis
Wound Infection
Patient Readmission
Sentinel Lymph Node Biopsy
Lymphedema
Incidence
Operating Rooms
Medical Records
Dissection
Lower Extremity
Length of Stay
Cohort Studies
Retrospective Studies
Prospective Studies

Cite this

Pontre, Jennifer ; Harding, Julia ; Chivers, Paola ; Loughlin, Leah ; Leung, Yee ; Salfinger, Stuart ; Tan, Jason ; Kader Ali Mohan, Raj ; Cohen, Paul. / Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer?. In: International Journal of Gynecological Cancer. 2018 ; Vol. 28, No. 1. pp. 183-187.
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title = "Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer?",
abstract = "OBJECTIVE: Sentinel lymph node biopsy has been widely adopted in the surgical management of women with early-stage vulvar cancer, but many patients require inguinofemoral lymphadenectomy (IFL). Following IFL, many surgeons drain the groin to prevent lymphocyst formation despite a lack of evidence to support this practice. Our objective was to investigate whether groin drains after IFL are associated with reduced postoperative morbidity in women undergoing surgery for vulvar cancer.METHODS:A retrospective cohort study of women diagnosed as having primary vulvar cancer who underwent vulvectomy/radical local excision and unilateral or bilateral IFL was conducted. Cases were ascertained from the weekly outcome reports of a statewide tertiary gynecologic oncology tumor board. Data including postoperative outcomes were abstracted from medical records. Patients were stratified into 1 of 2 groups according to whether a groin drain had been used.RESULTS:Seventy-one patients were included. Inguinal drains were used in 48 patients (67.6{\%}) and 23 patients (32.4{\%}) did not have their groin wound(s) drained. The most common postoperative complications recorded were wound infection (59.2{\%}), groin lymphocyst (32.4{\%}), and cellulitis (25.4{\%}). The mean length of hospital admission was 11.5 days (2-40 days). Compared with patients in whom inguinal drains were placed, those in the {"}no drain{"} group had a significantly lower incidence of postoperative groin cellulitis (8.7{\%} vs 25.4{\%} P = 0.039). No significant differences were observed between patients in the {"}drain{"} and {"}no drain{"} groups in lymphocyst formation, wound infection, return to the operating room, duration of hospital stay, readmission post-discharge, and lower-limb lymphedema.CONCLUSIONS:In this study of patients undergoing inguinofemoral dissection for primary vulvar cancer, postoperative cellulitis occurred less frequently in patients without an inguinal drain. The incidence of other postoperative complications was no different whether or not a groin drain was used. Prospective studies may be warranted.",
author = "Jennifer Pontre and Julia Harding and Paola Chivers and Leah Loughlin and Yee Leung and Stuart Salfinger and Jason Tan and {Kader Ali Mohan}, Raj and Paul Cohen",
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Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer? / Pontre, Jennifer; Harding, Julia; Chivers, Paola; Loughlin, Leah; Leung, Yee; Salfinger, Stuart; Tan, Jason; Kader Ali Mohan, Raj; Cohen, Paul.

In: International Journal of Gynecological Cancer, Vol. 28, No. 1, 01.2018, p. 183-187.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Do Groin Drains Reduce Postoperative Morbidity in Women Undergoing Inguinofemoral Lymphadenectomy for Vulvar Cancer?

AU - Pontre, Jennifer

AU - Harding, Julia

AU - Chivers, Paola

AU - Loughlin, Leah

AU - Leung, Yee

AU - Salfinger, Stuart

AU - Tan, Jason

AU - Kader Ali Mohan, Raj

AU - Cohen, Paul

PY - 2018/1

Y1 - 2018/1

N2 - OBJECTIVE: Sentinel lymph node biopsy has been widely adopted in the surgical management of women with early-stage vulvar cancer, but many patients require inguinofemoral lymphadenectomy (IFL). Following IFL, many surgeons drain the groin to prevent lymphocyst formation despite a lack of evidence to support this practice. Our objective was to investigate whether groin drains after IFL are associated with reduced postoperative morbidity in women undergoing surgery for vulvar cancer.METHODS:A retrospective cohort study of women diagnosed as having primary vulvar cancer who underwent vulvectomy/radical local excision and unilateral or bilateral IFL was conducted. Cases were ascertained from the weekly outcome reports of a statewide tertiary gynecologic oncology tumor board. Data including postoperative outcomes were abstracted from medical records. Patients were stratified into 1 of 2 groups according to whether a groin drain had been used.RESULTS:Seventy-one patients were included. Inguinal drains were used in 48 patients (67.6%) and 23 patients (32.4%) did not have their groin wound(s) drained. The most common postoperative complications recorded were wound infection (59.2%), groin lymphocyst (32.4%), and cellulitis (25.4%). The mean length of hospital admission was 11.5 days (2-40 days). Compared with patients in whom inguinal drains were placed, those in the "no drain" group had a significantly lower incidence of postoperative groin cellulitis (8.7% vs 25.4% P = 0.039). No significant differences were observed between patients in the "drain" and "no drain" groups in lymphocyst formation, wound infection, return to the operating room, duration of hospital stay, readmission post-discharge, and lower-limb lymphedema.CONCLUSIONS:In this study of patients undergoing inguinofemoral dissection for primary vulvar cancer, postoperative cellulitis occurred less frequently in patients without an inguinal drain. The incidence of other postoperative complications was no different whether or not a groin drain was used. Prospective studies may be warranted.

AB - OBJECTIVE: Sentinel lymph node biopsy has been widely adopted in the surgical management of women with early-stage vulvar cancer, but many patients require inguinofemoral lymphadenectomy (IFL). Following IFL, many surgeons drain the groin to prevent lymphocyst formation despite a lack of evidence to support this practice. Our objective was to investigate whether groin drains after IFL are associated with reduced postoperative morbidity in women undergoing surgery for vulvar cancer.METHODS:A retrospective cohort study of women diagnosed as having primary vulvar cancer who underwent vulvectomy/radical local excision and unilateral or bilateral IFL was conducted. Cases were ascertained from the weekly outcome reports of a statewide tertiary gynecologic oncology tumor board. Data including postoperative outcomes were abstracted from medical records. Patients were stratified into 1 of 2 groups according to whether a groin drain had been used.RESULTS:Seventy-one patients were included. Inguinal drains were used in 48 patients (67.6%) and 23 patients (32.4%) did not have their groin wound(s) drained. The most common postoperative complications recorded were wound infection (59.2%), groin lymphocyst (32.4%), and cellulitis (25.4%). The mean length of hospital admission was 11.5 days (2-40 days). Compared with patients in whom inguinal drains were placed, those in the "no drain" group had a significantly lower incidence of postoperative groin cellulitis (8.7% vs 25.4% P = 0.039). No significant differences were observed between patients in the "drain" and "no drain" groups in lymphocyst formation, wound infection, return to the operating room, duration of hospital stay, readmission post-discharge, and lower-limb lymphedema.CONCLUSIONS:In this study of patients undergoing inguinofemoral dissection for primary vulvar cancer, postoperative cellulitis occurred less frequently in patients without an inguinal drain. The incidence of other postoperative complications was no different whether or not a groin drain was used. Prospective studies may be warranted.

U2 - 10.1097/IGC.0000000000001146

DO - 10.1097/IGC.0000000000001146

M3 - Article

VL - 28

SP - 183

EP - 187

JO - International Journal of Gynecologic Cancer

JF - International Journal of Gynecologic Cancer

SN - 1048-891X

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