Long-term outcomes of vulvar or vaginal cancer patients undergoing laparoendoscopic single-site inguinal lymphadenectomy

Jing-Yun Xu; Tian-Xiang Yu; Xiao-Ming Guan; Bo Ding; Mu-Lan Ren; Yang Shen

doi:10.4103/jmas.jmas_268_22

Long-term outcomes of vulvar or vaginal cancer patients undergoing laparoendoscopic single-site inguinal lymphadenectomy

J Minim Access Surg. 2024 Apr 1;20(2):180-186. doi: 10.4103/jmas.jmas_268_22. Epub 2023 Jul 5.

Authors

Jing-Yun Xu¹, Tian-Xiang Yu², Xiao-Ming Guan³, Bo Ding¹, Mu-Lan Ren¹, Yang Shen¹

Affiliations

¹ Department of Obstetrics and Gynecology, School of Medicine, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China.
² Department of Obstetrics and Gynecology, School of Medicine, Southeast University, Nanjing, Jiangsu, China.
³ Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas, USA.

Abstract

Introduction: Laparoendoscopic single-site inguinal lymphadenectomy (LESS-IL), a minimally invasive technique, has been reported in patients with vulvar or vaginal cancer regarding its safety and feasibility. However, the long-term outcomes, especially oncologic outcomes, are still lacking. We aimed to evaluate the long-term outcomes of LESS-IL to confirm its safety further.

Patients and methods: Data were prospectively collected from patients with vulvar or vaginal cancer who underwent LESS-IL at our institution between July 2018 and June 2021. The patients were followed up for at least 12 months. All procedures were performed according to treatment standards. Short- and long-term complications and oncologic outcomes were analysed.

Results: A total of 16 patients undergoing 28 LESS-IL procedures were identified, amongst whom 4 underwent unilateral LESS-IL. The median numbers of excised groin lymph nodes were 9.0 (6.5-11.8) and 10.5 (8.3-12.0) in each left and right groin, respectively. Short-term complications occurred in 4 (25%) patients, including 18.7% lymphocele and 6.3% wound infection. Long-term complications regarding lower-limb lymphoedema appeared in 6 (37.5%) patients. Most short- and long-term complications were Clavien-Dindo 1 or 2, accounting for 90% of all post-operative issues. After a median follow-up of 27 (21.3-35.8) months, only 1 (6.3%) patient had isolated inguinal recurrence at 13 months postoperatively. No local or distant recurrence occurred.

Conclusion: Our results suggest that LESS-IL is associated with little incidence of complications and promising oncologic outcomes, further demonstrating the safety and feasibility of the LESS-IL technique in patients requiring IL.