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Background. At the end of 2019, a new coronavirus infection emerged in the People’s Republic of China. On March 11, 2020, the World Health Organization announced the start of the COVID­19 pandemic. During 2018, 2068 patients with malignant neoplasms of the vulva were identified, with the majority of patients aged 75–79 years. Surgical treatment is currently the main treatment method for vulva cancer (VC) patients. According to most authors, surgical treatment is the only method providing good long­term results. One of the approaches to reducing the volume of surgical treatment in such patients is the selective biopsy of the sentinel lymph node (SLN).Aim. To apply the method of SLN biopsy in VC patients with the purpose of reducing the amount of surgical treatment and surgical complications, as well as shortening hospital stay in the context of the COVID­19 pandemic.Materials and methods. This paper presents the results of surgical treatment of 19 patients with malignant neoplasms of the vulva. All the patients were at risk for a complicated course of COVID­19 due to age and concomitant pathologies. In 13 cases, vulvectomy with SLN biopsy was performed. SLN biopsy was performed by radioisotope lymphoscintigraphy.Results and discussion.A decrease in the duration of hospital stay and the absence of surgical complications characteristic of lymphadenectomies were noted.Conclusion. Reducing the duration of hospital stay in the context of the COVID­19 pandemic is an urgent task. The method of SLN biopsy in patients with invasive squamous cell carcinoma of the vulva with T1A — T2 was found to be effective, allowing the amount of surgical treatment to be reduced. Vulvectomy accompanied by SLN biopsy is the surgical treatment of choice in the context of strict anti­epidemiological measures in the COVID­19 pandemic.

Introduction. Vulvar cancer belongs to the group of rare neoplasms and accounts for about 4% of all gynecological malignant tumours. One of the important barriers to the spread of the tumour cell population is the lymph nodes. Most oncologists recognize the existence of the so-called sentinel lymph nodes. A proper assessment of the status of this node makes it possible to predict the extent of the spread of cancer, which in turn secures a better surgical treatment outcome.Materials and methods. 87 patients with vulvar malignant neoplasms received surgical treatment in 2015-2018 at the Department of Oncogynecology of the Republican Oncology Center. Vulvectomy was performed on 19 patients with verified vulvar cancer; sentinel lymph node detection was employed. The methods used were the contrast lymphography and indirect intraoperative radioisotope lymphoscintigraphy. This resulted in the minimal number of postoperative complications recorded.Results. The scope of surgical treatment for vulvar cancer was optimized based on sentinel lymph node verification.Conclusions. Detection of sentinel lymph nodes in vulvar cancer is an effective method of planning for the scope of the surgery. Using this method reduces the number of postoperative complications. The reduction of the number of postoperative complications improves the patients’ quality of life.

Incidence of vulvar cancer in reproductive patients and peculiarities of clinical course of the disease have been studied. 839 vulvar cancer patients aged 20-90 years have been treated at Gynecology Department of Rostov Research Oncologic Institute within the latest 30 years. The reproductive group (20-50 years of age) included 64 patients (7,6%). Early stages of vulvar cancer in the reproductive group were diagnosed more often than in elderly patients. Neurodystrophic changes of vulvar in young patients were much rarely observed in comparison with elderly patients. Almost 80% of patients under 40 years of age had human papilloma virus; in the group of 41-50 years of age – 50%; whereas in the elderly group contamination with human papilloma virus was observed only in single cases – 0,48%. Organ-sparing operations performed by strict individual approach are possible in the group of young patients. Vulvar cancer, in particular with advanced malignant process, requires complex treatment including neoadjuvant and multi-course adjuvant chemotherapy. Recurrent disease in reproductive patients is observed less frequent than in elderly patients. Chemotherapy is appropriate in cases of recurrent disease in order to improve operability.

Microbiological investigations were conducted vaginal cervix and vulva in 150 women with cancer of the vulva, of which 34 were the main group, 116-control. In order to prevent purulent-septic complications after surgery ectomy of the vulva women “at risk” a method for using medicinal herbs that have anti-inflammatory, antibacterial, wound-healing effect. Application of this technique allowed to reduce postoperative complications of the inflammatory nature of 2.6 times.