Search

Inguinal skin flap necrosis (SFN) is a significant clinical problem associated with inguinal lymph node dissection (ILND). The aetiology of SFN is multifactorial, and its manifestations vary widely. Thermal damage caused by electrocautery during the elevation of the skin flap may contribute to this problem, which has not been studied previously. This prospective, observational study included patients undergoing ILND from January 2020 to July 2022. Based on the technique of raising the inguinal skin flaps, the patients were divided into two groups (cold knife or electrocautery). The remaining part of the procedure was the same. The inguinal wound was examined and photographed to assess the SFN. A total of 42 patients were included (21 in each group). Age, gender, body mass index (BMI), alcohol or tobacco consumption, immune compromised status, and serum albumin were comparable (p > 0.05). The average time required to elevate flaps was 13.14 vs. 11.47 min (p = 0.0231), and gauze soakage was 2.05 vs. 1.52 (p < 0.0001) with a cold knife compared to electrocautery. The incidence of SFN and surgical site infection (SSI) was significantly lower with the use of a cold knife [4.8% vs. 33.3% (p = 0.045) and 0% vs. 19% (p = 0.0378)]. Grade 3 necrosis was observed only with electrocautery use. Compared to conventional electrocautery, the cold knife technique lowers the incidence of SFN and SSI. Further research with a larger sample size and a standardized definition is needed to validate these results. [ABSTRACT FROM AUTHOR]

Background: Inguinal lymph node dissection (ILND) is the standard of care for palpable, biopsy-proven lymph node metastases or high-risk groups for nonpalpable lymph nodes in the treatment of penile cancer. ILND is associated with a significant incidence of complications and adverse events, specifically wound complications. Few studies have identified risk factors related to postoperative ILND complications. Objective: The objective of this study was to assess the prevalence of 30-day postoperative complications and to identify risk factors associated with postoperative complications of ILND for penile cancer. Materials and Methods: This was a retrospective review of medical records for all patients who had ILND for penile cancer between January 2012 and December 2022. According to the modified Clavien–Dindo classification, the 30-day postoperative complications were collected. Using an ordinal univariate logistic regression model and multivariate analysis, potential risk variables for complications were determined. Results: A total of 60 patients were performed ILND. Sixty percent of the patients had a postoperative complication including wound infection 50%, wound dehiscence 36.7%, skin necrosis 26.6%, lymphocele 33.3%, leg edema 46.7%, and scrotal edema 16.7%. Higher grade of modified Clavien–Dindo classification was associated with body mass index (BMI) (odds ratio [OR] = 1.15; P = 0.03), diabetes mellitus (OR = 3.13; P = 0.04), American Society of Anesthesiologist classification ≥3 (OR = 1.14; P = 0.03), radical ILND (OR = 1.57; P = 0.01), and bilateral ILND (OR = 1.60; P = 0.02). In multivariate analysis, a higher grade of modified Clavien–Dindo classification was correlated with BMI (OR = 1.48; P = 0.01) and bilateral ILND (OR = 4.56; P = 0.01). Conclusion: ILND is associated with high rates of complication. The severity of the modified Clavien–Dindo classification was associated with BMI and bilateral ILND.

Mise à jour des recommandations de prise en charge du pénis. Revue exhaustive de la littérature effectuée sur PubMed depuis 2022 concernant le diagnostic, le traitement et le suivi des tumeurs du pénis. Le niveau de preuve des références a été évalué. Au total 95 % des cancers du pénis infiltrants sont des carcinomes épidermoïdes, dont un tiers en rapport avec une infection à Human Papillomavirus (HPV). L'examen clinique permet d'identifier la taille de la lésion, sa localisation, sa proximité avec le méat urétral, son infiltration en profondeur. L'interrogatoire doit évaluer les fonctions urinaire et sexuelle. L'IRM est l'imagerie de référence pour le bilan local. Les tumeurs du pénis sont classées en faible risque (≤ pT1a et bien différencié G1), de risque intermédiaire (pT1a G2), à haut risque (≥ pT1b, ou G3, ou contingent sarcomatoïde). L'évaluation ganglionnaire du cancer du pénis est fondamentale. La technique du ganglion sentinelle est recommandée pour l'évaluation des patients cN0 ayant une tumeur de risque intermédiaire ou plus. La TEP 18FDG est recommandée chez le patient cN+. La chirurgie est le traitement de référence localement et est fonction de la taille, de la localisation et du grade de la tumeur. Un traitement topique ou par curiethérapie peut être indiqué dans certains cas. Un curage inguinal radical (CIR) est recommandé pour les stades cN1/cN2. Une chimiothérapie néoadjuvante est recommandée pour les stades cN3, associée à un CIR chez les patients répondeurs. Les formes métastatiques peuvent faire l'objet de chimiothérapie palliative, et d'immunothérapie dans le cadre d'un essai clinique. Le traitement du cancer du pénis est essentiellement chirurgical plus ou moins associé à une chimiothérapie en cas d'extension ganglionnaire. Le facteur pronostique principal est l'atteinte ganglionnaire justifiant une prise en charge diagnostique et thérapeutique précoce des aires inguinales. To update recommendations for the management of penile lesion. Comprehensive review from 2022 of the literature performed on PubMed since 2022 concerning the diagnosis, treatment and follow-up of penile tumors. The level of evidence of the references was assessed. A total of 95 % of invasive infiltrating penile cancers are squamous cell carcinomas, a third of which are related to Human Papillomavirus (HPV) infection. Clinical examination can help identify the size of the lesion, its location, its proximity to the urethral meatus, and its deep infiltration. Questioning should assess urinary and sexual function. MRI is the gold standard reference imaging tool for local assessment. Penile tumors are classified as low-risk (≤ pT1a and well-differentiated G1), intermediate-risk (pT1a G2) and), high-risk (≥ pT1b, or G3, or sarcomatoid contingent). Lymph node assessment in penile cancer is fundamental. The sentinel node technique is recommended for the evaluation of cN0 patients with tumors of intermediate risk or higher. 18FDG PET is recommended for cN+ patients. Surgery is the gold standard for local treatment and depends, depending on the tumour size, location and grade of the tumor. Topical treatment or brachytherapy may be indicated in some certain cases. Topical treatment or brachytherapy may be indicated in certain cases. Radical inguinal lymphadenectomy (RIL curettage (RIC) is recommended for stages cN1/cN2. Neoadjuvant stages. Neo-adjuvant chemotherapy is recommended for cN3 stages, combined with RILRIC in responders. Metastatic forms may be treated with palliative chemotherapy, and immunotherapy as part of a clinical trial. Treatment of penile cancer is essentially surgical, with or without chemotherapy in the case of lymph node involvement extension. The main prognostic factor is lymph node involvement, which justifies early diagnostic and therapeutic management of the inguinal areas. [ABSTRACT FROM AUTHOR]

Background: Inguinal lymph node dissection (ILND) is the standard of care for palpable, biopsy-proven lymph node metastases or high-risk groups for nonpalpable lymph nodes in the treatment of penile cancer. ILND is associated with a significant incidence of complications and adverse events, specifically wound complications. Few studies have identified risk factors related to postoperative ILND complications. Objective: The objective of this study was to assess the prevalence of 30-day postoperative complications and to identify risk factors associated with postoperative complications of ILND for penile cancer. Materials and Methods: This was a retrospective review of medical records for all patients who had ILND for penile cancer between January 2012 and December 2022. According to the modified Clavien–Dindo classification, the 30-day postoperative complications were collected. Using an ordinal univariate logistic regression model and multivariate analysis, potential risk variables for complications were determined. Results: A total of 60 patients were performed ILND. Sixty percent of the patients had a postoperative complication including wound infection 50%, wound dehiscence 36.7%, skin necrosis 26.6%, lymphocele 33.3%, leg edema 46.7%, and scrotal edema 16.7%. Higher grade of modified Clavien–Dindo classification was associated with body mass index (BMI) (odds ratio [OR] = 1.15; P = 0.03), diabetes mellitus (OR = 3.13; P = 0.04), American Society of Anesthesiologist classification ≥3 (OR = 1.14; P = 0.03), radical ILND (OR = 1.57; P = 0.01), and bilateral ILND (OR = 1.60; P = 0.02). In multivariate analysis, a higher grade of modified Clavien–Dindo classification was correlated with BMI (OR = 1.48; P = 0.01) and bilateral ILND (OR = 4.56; P = 0.01). Conclusion: ILND is associated with high rates of complication. The severity of the modified Clavien–Dindo classification was associated with BMI and bilateral ILND. [ABSTRACT FROM AUTHOR]

Objectives: Penile carcinoma (PC) is a rare disease with considerable physical and psychological impact. To date, there is no data regarding PC prevalence and characteristics in Indonesia. This study aimed to analyze the characteristics of patients with PC in Indonesia and determine cumulative survival rates and time to disease progression. Methods: This was a retrospective study of all patients diagnosed with PC at Cipto Mangunkusumo General Hospital from 1995 to 2014, with a minimum of 1 year follow‐up. The outcomes of the study were cumulative survival rates and time‐to‐disease progression. Results: Ninety‐three subjects were recruited, with a mean age of 49.44 ± 13.62. Inguinal lymph node dissection (ILND) was performed in 49 (53%) patients. The mean survival in the ILND group was better compared to the non‐ILND group (80.7 months vs. 67.1 months; p = 0.032). Time‐to‐progression in the ILND group was significantly longer than in the non‐ILND group (71.7 months vs. 54.3 months; p = 0.022). No significant difference in survival between the total and partial penectomy (PP) groups was observed (p = 0.701). Time‐to‐progression in total penectomy (TP) was significantly longer than in PP (68 months vs. 56.0 months; p = 0.023). In Cox‐regression analysis, after adjustment of other variables, history of ILND, higher stage of cancer, and older age were found to affect the survival of patients. Conclusion: ILND in PC led to better survival and reduced disease progression. The type of penectomy is only associated with progression but not survival. TP had a longer time to disease progression compared to PP. [ABSTRACT FROM AUTHOR]

Background: Penile squamous cell carcinoma (SCC) is a rare malignancy with a high propensity for regional dissemination. While current guidelines recommend inguinal lymph node dissection (ILND) for patients with high-risk features, the surgery carries a high risk of lymphedema [1]. Indocyanine Green (ICG)-guided lymphangiography has been used to increase nodal yield and detection rates in lymph node dissections [2]. Objectives: To demonstrate that “reverse” ICG-guided ILND is a safe and novel technique that may reduce rates of postoperative lymphedema in penile cancer patients and may intraoperatively help identify candidates for lymphovascular anastomosis (LVA). Methods: To evaluate the efficacy of “reverse” ICG-guided ILND, 2.5 mg mixed ICG solution was injected superficially into the intradermal layer at the first and fourth interdigital spaces of the foot prior to beginning robotic-assisted bilateral ILND. The lower extremity lymphatic channels are prospectively identified and preserved during dissection with the aid of near infrared fluorescence imaging. Results: A total of 9 groin dissections have been completed using this technique. Reverse lymphatic mapping was successful in 7 out of 9 (77.7 %) groin dissections. With a follow-up range of 0.9–24 months, there have been no instances of post-operative lymphedema in patients who underwent successful mapping. Conclusion: Reverse lymphatic mapping during robot-assisted inguinal lymphadenectomy is a safe and feasible technique. Enhanced intraoperative visualization of lymphatic structures not only may help minimize the risk of postoperative lymphedema, but it may also help identify those patients at high risk of developing lymphedema and allow for prophylactic interventions. Further investigation is necessary to establish the oncologic safety of reverse lymphatic mapping during ILND.

Malignant melanoma, a highly aggressive skin cancer, accounts for 75% of skin cancer-related deaths. This case report details a 59-year-old Sudanese male with a malignant melanoma of the left foot, presenting with nodal melanosis, a rare condition involving benign pigmented deposits in the lymph nodes. The patient underwent below-knee amputation and inguinal lymph node dissection. Significant black discoloration was observed in the lymph nodes, indicating nodal melanosis. Histopathological examination of excised lymph nodes confirmed the presence of both malignant melanoma and benign melanosis. Despite surgical intervention, the patient eventually developed distant metastases, including lung nodules and a liver lesion. This case underscores the importance of recognizing nodal melanosis in metastatic malignant melanoma and highlights the challenges of managing advanced cases in resource-limited settings. Surgical management remains critical, particularly wide resection and lymph node dissection, even as systemic therapies advance. [ABSTRACT FROM AUTHOR]

Lymphatic spread of colon cancer usually occurs via mesenteric vessels (superior and inferior mesenteric vessels), but inguinal lymph node (LN) metastasis from colon cancer is extremely rare with only few reported cases in the literature. A case of a 35-year-old female patient with a history of sigmoid cancer underwent sigmoidectomy and left salpingo-oopherectomy in 2016 and received adjuvant chemotherapy then presented in 2023 with metastatic left inguinal LNs and underwent left inguinal LN dissection. We reported a rare case of isolated metachronous inguinal lymph node metastasis from colon cancer with a round ligament route of spread as the hypothesized mechanism. Surgical resection with inguinal LN dissection is the preferred treatment option for isolated inguinal lymph node metastasis from colon cancer followed by adjuvant chemotherapy, yet long term follow-up data is needed to support this strategy. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the safety and efficacy of indocyanine green (ICG) fluorescence‐guided inguinal lymph node dissection (ILND) in patients with penile cancer. Patients and Methods: A prospective, single‐blind, randomised controlled clinical trial (ChiCTR2100044584) was performed among patients with penile caner who underwent bilateral modified ILND at four centres in China between 1 April 2021 and 30 June 2022. Patients aged 18–80 years and diagnosed with squamous cell carcinomas were included. Each enrolled patient was randomly assigned to either ICG fluorescence‐guided ILND by a laparoscopic or robot‐assisted approach in one groin, with non‐ICG fluorescence‐guided ILND in the other groin acting as a control. The primary outcome was the number of retrieved ILNs. Secondary outcomes included complications according to the Clavien–Dindo classification and the ILN non‐compliance (inadequate removal of ILNs) rate. Results: A total of 45 patients were included in the intention‐to‐treat (ITT) analysis, and the 42 who completed the entire study were included in the per protocol (PP) analysis. There were no ICG‐related complications in any of the patients. The results of the ITT and PP analyses indicated that the total number of unilateral ILNs retrieved was higher on the ICG side than on the non‐ICG side (mean 13 vs 9 ILNs, difference 4 ILNs [95% CI 2.7–4.4], P = 0.007), and the number of unilateral deep and superficial ILNs was higher on the ICG side. Furthermore, the LN non‐compliance rate was lower on the ICG side than on the non‐ICG side. Additionally, there was no significant difference in local complications in the groins between the two sides (P > 0.05). Conclusion: An ICG fluorescence‐guided ILND was safe for patients with penile cancer. This procedure can improve the number of ILNs retrieved and reduce the LN non‐compliance rate without increased complications. ICG fluorescence‐guided ILND is beneficial and recommended for selected patients with penile cancer. [ABSTRACT FROM AUTHOR]

Introduction: Inguinal lymph node dissection (ILND) plays an important role for both staging and treatment purposes in patients diagnosed with penile carcinoma (PeCa). Video–endoscopic inguinal lymphadenectomy (VEIL) has been introduced to reduce complications, and in those patients elected for bilateral ILND, a simultaneous bilateral VEIL (sB-VEIL) has also been proposed. This study aimed to investigate the feasibility, safety, and preliminary oncological outcomes of sB-VEIL compared to consecutive bilateral VEIL (cB-VEIL). Material and methods: Clinical N0-2 patients diagnosed with PeCa and treated with cB-VEIL and sB-VEIL between 2015 and 2023 at our institution were included. Modified ILND was performed in cN0 patients, while cN+ patients underwent a radical approach. Intra- and postoperative complications, operative time, time of drainage maintenance, length of hospital stay and readmission within 90 days, as well as lymph node yield, were compared between the two groups. Results: Overall, 30 patients were submitted to B-VEIL. Of these, 20 and 10 patients underwent cB-VEIL and sB-VEIL, respectively. Overall, 16 (80%) and 7 (70%) patients were submitted to radical ILND due to cN1-2 disease in the cB-VEIL and sB-VEIL groups, respectively. No statistically significant difference emerged in terms of median nodal yield (13.5 vs. 14, p = 0.7) and median positive LNs (p = 0.9). sD-VEIL was associated with a shorter operative time (170 vs. 240 min, p < 0.01). No statistically significant difference emerged in terms of intraoperative estimated blood loss, length of hospital stay, time to drainage tube removal, major complications, and hospital readmission in the cB-VEIL and sB-VEIL groups, respectively (all p > 0.05). Conclusions: Simultaneous bilateral VEIL is a feasible and safe technique in patients with PeCA, showing similar oncological results and shorter operative time compared to a consecutive bilateral approach. Patients with higher preoperative comorbidity burden or anesthesiological risk are those who may benefit the most from this technique. [ABSTRACT FROM AUTHOR]

Joshua White,1 Ross Mason,2 Tarek Lawen,2 Jesse Spooner,2 Kauy VM Faria,3 Farah Rahman,1 Ranjith Ramasamy1 1Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Urology, Dalhousie University, Halifax, NS, Canada; 3Department of Urology, Institute of Cancer of São Paulo, University of São Paulo School of Medicine, Sao Paulo, BrazilCorrespondence: Ranjith Ramasamy, University of Miami, Miller School of Medicine, 1120 NW 14th Street, 15th Floor, Miami, FL, 33136, USA, Tel +1 201 388-6644, Email ramasamy@miami.eduAbstract: Penile cancer is a rare malignancy, most commonly diagnosed in older men, associated with poor outcomes, dramatic decline in quality of life and sexual function. Squamous cell carcinoma is the most common histopathology of penile cancer, accounting for 95% of all cases. Localized, early-stage penile cancer can be effectively managed through penile-sparing techniques in many cases, though advanced stages of penile cancer carry a poor prognosis. Current innovative treatments are exploring the role of targeted therapy, HPV-directed therapy, immune checkpoint inhibitors and adoptive T-cell therapies in treatment and prevention of relapse of penile cancer. Clinical trials are investigating the potential of targeted therapies and immune checkpoint inhibitors in advanced penile cancer. This review examines the current management of penile cancer and highlights future directions in research and treatment.Keywords: penile cancer, inguinal lymph node dissection, immunotherapy, targeted therapy, HPV, adoptive T-cell therapy, sexual function

The article presents a clinical case of perineal defect reconstruction using a VRAM flap in a patient with vulvar cancer. Stepwise surgical treatment method is described. A multidisciplinary meeting allows to realize a plan of surgical help for such patients with the goal of treating oncological process and its complications.We have proposed a variant of perineal defect reconstruction through transfer of a vertical rectus abdominis musculocutaneous flap with a vascular pedicle.

To assess the long-term risks of infectious and thromboembolic events following inguinal (ILND) and pelvic (PLND) lymph node dissection in men with penile cancer. A total of 364 men subjected to ILND with or without PLND for penile cancer between 2000 and 2012 were identified in the Swedish National Penile Cancer Register. Each patient was matched based on age and county of residence with six penile cancer-free men. The Swedish Cancer Register and other population-based registers were used to retrieve information on treatment and hospitalisation for selected infectious and thromboembolic events. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with multiple imputation. The risk of infectious events remained increased for more than five years postoperatively in men with penile cancer compared with matched controls. The palpable nodal disease was the only predictor of these events, with risk increasing with the cN stage. The HR at one, three and five years and six months postoperatively was 8.60 (95% CI 5.16–14.34), 4.02 (95% CI 2.65–6.09) and 1.93 (95% CI 1.11–3.38), respectively. An increased risk of thromboembolic events persisted for three years postoperatively. The HR at one and three years postoperatively was 13.51 (95% CI 6.53–27.93) and 2.12 (95% CI 1.07–4.20). The results correspond well with the over-prescription of anticoagulants observed during this period. An association with bulky disease (cN3) was observed. Lymph node dissection for penile cancer is associated with an increased risk of infectious and thromboembolic events. The findings of this population-based study show that the risks of these events remain increased more than five years for infectious and three years for thromboembolic events. Improved awareness of long-term complications following ILND is of importance both among patients and care givers to ensure early detection and treatment. [ABSTRACT FROM AUTHOR]

Purpose: This study was done to find out the clinicopathological characteristics of carcinoma penis in Nepali population and to evaluate various risk factors that predict its inguinal lymph node metastasis. Methods: A retrospective cross-sectional study was carried out at the Urology Unit, Department of Surgical Oncology at BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal. Case notes of biopsy-proven penile cancer, from January 2012 to December 2021, who underwent some form of surgical intervention were included. Results: A total of 380 patients were included in the study. The mean age of the patients was 55.92 ± 13.81 years. At presentation, 78.5% had clinically node-positive disease. The most common treatment for the primary tumor was partial amputation of the penis (74.2%). Bilateral inguinal lymph node dissections were done in 370 cases. The most common histology was the usual SCC in 94.2% of cases and 69% were well differentiated. T3 was the most common staging in 49.4% cases. Pathologically nodal negative status was found in 58% cases. In univariate analysis, factors like duration of symptoms (≥ 6 months), high-risk histopathology (basaloid/sarcomatoid variant), increased T-stage, poorly differentiated tumor, and the presence of PNI or LVI were significantly associated with lymph node metastasis. Conclusions : Penile cancer is a common cancer in developing countries such as Nepal. The majority of the patients present late. Early recognition and prompt treatment are required to improve the overall outcome. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of robot-assisted laparoscopic antegrade inguinal lymph node dissection for patients with penile cancer. Methods A retrospective study was performed on clinical data from 10 patients with penile cancer admitted to the First Affiliated Hospital of Army Medical University from March 2019 to January 2020. All of them were diagnosed with penis squamous cell carcinoma by pathological diagnosis. Robot-assisted laparoscopic antegrade inguinal lymphadenectomy was performed for all patients under general anesthesia. Results The surgery was successfully accomplished at totally 20 sides without intraoperative conversion to open surgery. The operation time was 87.90±11.58 (80~119) min, intraoperative blood loss was 12.50±8.90 (5~25) mL, and number of removed lymph nodes was 22.90±8.90 (10~35). The positive lymph nodes were 6 in 1 case at T2 stage, 3 in 1 case at T2 stage, 3 in 1 case at T1 stage and 2 in 1 case at T1 stage. The postoperative hospital stay was 2.80±1.23 (2~5) d, and the indwelling time of drainage tube was 17.10±3.63 (7~27) d. None of the patients experienced skin necrosis, bleeding, lymphatic fistula, infection and other complications. During the follow-up time of 16.40±6.79 (14~24) months, recurrence and metastasis were found in only 1 case, and not in the other 9 cases. Conclusion Robot-assisted laparoscopic antegrade bilateral inguinal lymphadenectomy is a safe and effective dissection for penile cancer, which can reduce complications and promote rapid recovery after surgery.

Purpose: Rectal or anal canal adenocarcinoma with inguinal lymph node metastasis (ILNM) is rare and is associated with poor prognostic outcomes. This study aimed to elucidate the clinical significance of neoadjuvant therapy followed by selective inguinal lymph node dissection and total mesorectal excision for rectal or anal canal adenocarcinoma with clinically suspected ILNM. Methods: This study enrolled 15 consecutive patients who underwent neoadjuvant therapy and curative resection for rectal or anal canal adenocarcinoma with clinically suspected ILNM between 2005 and 2019 at a single institution. Inguinal lymph node dissection was selectively performed on the side of suspected metastasis before neoadjuvant therapy. Short- and long-term outcomes were retrospectively reviewed. Results: Out of the15 patients, 11 were treated with neoadjuvant chemoradiation, three with chemotherapy, and one with chemoradiation followed by chemotherapy. Fluorodeoxyglucose (FDG)–positron emission tomography (PET) scans were performed after neoadjuvant therapy in 14 patients. Five patients had negative FDG accumulation in inguinal lymph nodes on FDG-PET scan, and their inguinal lymph nodes were also pathologically negative for metastasis. Of the nine patients who had positive FDG accumulation, four had pathologically positive inguinal lymph nodes. Seven patients (46.7%) had inguinal seroma postoperatively. Five-year-overall survival was 77.5%, and 5-year-relapse-free survival was 64.2%. No patient had a recurrence in the inguinal region. Conclusion: In patients with rectal or anal canal adenocarcinoma associated with clinical ILNM, radical resection with neoadjuvant therapy provides a good long-term survival. [ABSTRACT FROM AUTHOR]

Purpose: To assess the morbidity of inguinal lymph node dissection (ILND) in penile cancer, then to compare this morbidity with that of ILND performed in the context of skin cancer treatment. Methods: We retrospectively included all patients having undergone ILND between 1 January 2004 and 31 December 2019 in our centre's urology department in the context of treatment of penile cancer or skin cancer. Postoperative complications were reported in accordance with the Clavien–Dindo classification system. Results: Two hundred forty-two ILNDs were performed in 122 patients with penile cancer and 56 ILNDs were performed in 56 patients with skin cancer. The most common early complication was postoperative fluid collection (lymphocele or haematoma), which complicated 44% of ILNDs overall and 60% of radical lymphadenectomies. The most common late complication was leg lymphoedema, found in up to 36% of radical lymphadenectomies. Major complications (grade ≥ III) were very rare (4% of radical lymphadenectomies). Radical lymphadenectomies resulted in significantly more cases of postoperative fluid collection, skin necrosis and dehiscence, as well as leg lymphoedema, than modified lymphadenectomy techniques. Two factors significantly increasing postoperative morbidity were demonstrated: ASA score = 3 (OR = 3.09) and operating time (OR = 1.01). Conclusion: ILNDs are morbid surgical procedures for which the indications must be well defined. However, the complications are almost exclusively minor, for a major oncological benefit. [ABSTRACT FROM AUTHOR]

Background: Open inguinal lymph node dissection (oILND) has high morbidity. Ascending saphenous-sparing video endoscopic ILND (VEILND-AS+) represents a minimally invasive alternative with potential benefits. Objective: To describe our VEILND-AS+ technique and compare outcomes to oILND. Design, setting, and participants: This was a retrospective cohort study of penile cancer patients. Surgical procedure: VEILND-AS+ was performed according to the technique described in the supplementary video. Measurements: We compared perioperative and pathological outcomes between the two procedures. Results and limitations: In the study cohort of 206 men we performed 40 VEILND-AS+ and 251 oILND procedures. In comparison to oILND, VEILND-AS+ had a longer operation time (185 vs 120 min; p < 0.01) but a shorter hospital stay (2 vs 4 d; p < 0.01). A median of eight resected lymph nodes with a median of one affected node per groin was observed in both groups. Extranodal extension was found in 30% of cases after VEILND-AS+ and 35% after oILND. In both groups the median drainage time was 13 d. Wound infections were observed in 38% of cases after VEILND-AS+ and 27% after oILND (p = 0.19). Skin necrosis or wound breakdown occurred in 0% and 6% of cases after VEILND-AS+ and oILND (p < 0.01), while lymphoceles were drained in 18% and 7% of cases, respectively(p = 0.03). Following VEILND-AS+ and oILND, 20% and 14% of patients, respectively, were referred to a lymph oedema clinic (p < 0.01). Conclusions: VEILND-AS+ is a safe procedure and offers shorter hospital stays and possibly a lower risk of skin necrosis and wound breakdown in comparison to oILND. Further improvements in the VEILND-AS+ technique are required to reduce complications associated with dead space and injury to lymphatic vessels. Patient summary: For patients undergoing surgery on lymph nodes in the groin, a minimally invasive approach instead of open surgery led to discharge 2 days earlier and may have lower rates of severe wound complications.

Skin cancer patients with clinical nodal disease or whose positive sentinel nodes had great tumor burden remain candidates for regional lymph node dissections. Among these patients, inguinal or ilioinguinal lymph node dissection is frequently required in clinical practice, which is associated with significant postoperative morbidity—including lymphatic leakage. The aim of this retrospective study was to evaluate the efficacy of LigaSure™, an electrothermal bipolar vessel sealing system, in reducing lymphatic leakage in inguinal or ilioinguinal lymph node dissection. In total, 58 patients who received inguinal or ilioinguinal lymph node dissection (conventional group, 48; LigaSure™ group, 10) and shared similar characteristics were included in this study. Lymphatic leakage after drain removal was significantly lower in the LigaSure™ group than that in the conventional group (present ratio, 0% vs. 37%; p = 0.02). The daily lymphatic drainage volume also tended to be lower in the LigaSure™ than that in the conventional group, with significant differences on postoperative day 1 (p = 0.02). Other perioperative outcomes including the operating time, intraoperative blood loss, time to drain removal, duration of hospital stay, flap necrosis, and wound infection showed no significant differences between the two groups. The use of the LigaSure™ in inguinal or ilioinguinal lymph node dissection for the treatment of skin cancer could reduce the incidence of postoperative lymphatic leakage after drain removal. [ABSTRACT FROM AUTHOR]

Inguinal lymph node status is the single most important prognostic factor for survival in patients with carcinoma penis. Various modifications and alternatives to open inguinal lymph node dissection have been developed as the same is associated with high postoperative morbidity such as wound infection, skin flap necrosis, lymphorrhea, and lymphedema. Robot-assisted video endoscopic inguinal lymph node dissection (RA-VEIL) has the potential to accomplish thorough inguinal lymph node dissection with definitively reduced postoperative morbidity. In this video, we demonstrate our technique of RA-VEIL: The fascia lata first approach and highlight our technical modifications of the conventionally described procedure. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the rate of groin recurrence among women undergoing superficial or deep inguinal lymph node dissections in suspected early-stage vulvar carcinoma. Secondary objectives included comparison of overall survival and post-operative morbidity between the study groups. A retrospective cohort of 233 patients with squamous cell carcinoma (SCC) of the vulva who underwent an inguinal lymph node dissection at two major academic institutions from 1999 to 2017 were analyzed. Demographic, surgical, recurrence, survival, and post-operative morbidity data were collected for 233 patients, resulting in a total of 400 groin node dissections analyzed. Rates of overall primary recurrence of disease between superficial and deep inguinal LND (42.5 vs. 39.8%, p = 0.70) and rates of inguinal recurrence (3.4 vs. 8.3%, p = 0.16) were similar. Overall rates of postoperative morbidity were significantly higher in the cohort undergoing deep LND (70.3% vs 44.3%, p < 0.01). Rates of lymphedema (42.4 vs 15.9%, p < 0.01), readmission (26.3 vs 6.8%, p < 0.01), and infection (40.7 vs 14.8%, p < 0.01) were all significantly higher among patients undergoing deep LND. There was no significant difference noted in overall survival between the study groups when adjusting for stage and age (HR 1.08, p = 0.84). Superficial inguinal LND had no significant difference in rate of recurrence or overall survival when compared to deep inguinal LND in patients with vulvar SCC. Those who received a deep LND had a significant increase in overall morbidity, including lymphedema, readmission, and infection. For patients who cannot undergo or fail sentinel lymph node mapping, a superficial inguinal lymph node dissection may have similar outcomes in recurrence and overall survival with a reduction in overall morbidity as compared to a complete, or deep, lymph node dissection. • Superficial inguinal LND had no significant difference in rate of recurrence or overall survival when compared to deep inguinal LND in patients with vulvar SCC. • Superficial inguinal lymph node dissection may be safe and feasible in patients who are not a candidate for sentinel lymph node biopsy with vulvar cancer. • Superficial inguinal lymph node dissection is associated with a significant reduction in post-operative morbidity as compared to full inguinal lymph node dissection. [ABSTRACT FROM AUTHOR]

Objective: To develop a predictive model for additional inguinal lymph node metastases (LNM) at inguinal lymph node dissection (ILND) after positive dynamic sentinel node biopsy (DSNB) using DSNB characteristics to identify a patient group in which ILND might be omitted. Patients and Methods: We conducted a retrospective study of 407 inguinal basins with a positive DSNB in penile cancer patients who underwent subsequent ILND from seven European centres. From the histopathology reports, the number of positive and negative lymph nodes, presence of extranodal extension and size of the metastasis were recorded. Using bootstrapped logistic regression, variables were selected for the clinical prediction model based on the optimization of Akaike's information criterion. The area under the curve (AUC) of the receiver‐operating characteristic curve was calculated for the resulting model. Decision curve analysis (DCA) was used to evaluate the clinical utility of the model. Results: Of the positive DSNBs, 64 (16%) harboured additional LNM at ILND. Number of positive nodes at positive DSNB (odds ratio [OR] 2.19, 95% confidence interval (CI) 1.17–4.00; P = 0.01) and largest metastasis size in mm (OR 1.06, 95% CI 1.03–1.10; P = 0.001) were selected for the clinical prediction model. The AUC was 0.67 (95% CI 0.60–0.74). The DCA showed no clinical benefit of using the clinical prediction model. Conclusion: A small but clinically important group of basins harbour additional LNM at completion ILND after positive DSNB. While DSNB characteristics were associated with additional LNM, they did not improve the selection of basins in which ILND could be omitted. Thus, completion ILND remains necessary in all basins with a positive DSNB. [ABSTRACT FROM AUTHOR]

Dynamic sentinel lymph node biopsy (DSNB) and radical inguinal lymph node dissection (ILND) are important in the management of penile cancer patients, but high-level evidence for preoperative, perioperative, and postoperative management remains scarce. According to an online survey of 35 surgeons from ten European countries, 57% perform >10 ILND procedures per year and 86% offer DSNB. Furthermore, management differs substantially for dye injection site, use of lymphoscintigraphy, preferred incision sites, techniques for lymphatic control, duration of empiric antibiotic therapy, perioperative thromboprophylaxis, time points for drain removal, and definition of the ILND dissection floor. Consensus was observed for the use of perioperative antibiotics (although not duration and type) and the borders for ILND template definitions. We conclude that there is significant variation in patient management among eUROGEN penile cancer surgeons. This heterogeneity may confound multicentre studies; therefore, a consensus to standardise inguinal node management in penile cancer across European penile cancer centres is warranted. Patient summary: Our survey reveals that preferences and surgical techniques for inguinal lymph node sampling and removal varies significantly between European penile cancer surgeons. Consensus is needed to standardise the management approach for penile cancer.

Objective: Update of the recommendations for the management of penile lesions., Materials and Methods: Comprehensive PubMed review from 2022 of the literature on the diagnosis, treatment and follow-up of penile tumours. The level of evidence of the studies was assessed., Results: A total of 95% of infiltrating penile cancers are squamous cell carcinomas, one-third of which are related to human papillomavirus (HPV) infection. Clinical examination can reveal the size of the lesion, its location, its proximity to the urethral meatus and its infiltration depth. Urinary and sexual function should be assessed. Magnetic resonance imaging (MRI) is the gold standard for local assessment. Penile tumours are classified as low-risk (≤pT1a and well-differentiated G1), intermediate-risk (pT1a G2) or high-risk (≥pT1b, G3, or sarcomatoid contingent). Lymph node assessment in penile cancer is fundamental. The sentinel node technique is recommended for the evaluation of cN0 patients with tumours of intermediate risk or higher. 18FDG PET is recommended for cN+ patients. Surgery is the standard treatment locally and depends on the size, location and grade of the tumour. Topical treatment or brachytherapy may be indicated in some cases. Radical inguinal curettage (RIC) is recommended for stages cN1/cN2. Neoadjuvant chemotherapy is recommended for patients with cN3-stage lesions, combined with RIC in responders. Metastatic forms may be treated with palliative chemotherapy and immunotherapy as part of a clinical trial., Conclusion: The treatment of penile cancer is essentially surgery, with or without chemotherapy in the case of lymph node involvement. The main prognostic factor is lymph node involvement, which justifies early diagnostic and therapeutic management of the inguinal areas., (Copyright © 2024 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.)

Open inguinal lymph node dissection (O-ILND) is the gold standard in the management of lymph nodes in carcinoma penis; however, video endoscopic inguinal lymphadenectomy (VEIL) is performed in some centers. Our primary objective is to compare perioperative and survival outcomes in patients undergoing VEIL with O-ILND, as very few studies have reported long-term survival outcomes till date. We analyzed patients who underwent O-ILND and VEIL (laparoscopic or robot-assisted) from January 2009 to January 2020 in our institute for carcinoma of the penis. Patient details, perioperative complications, and survival outcomes were analyzed. Perioperative outcomes were analyzed by logistic regression and survival outcomes by log-rank and Cox regression methods. We analyzed 79 patients (32 O-ILND, 47 VEIL) with a median follow-up of 51 (IQR 25.5–75.5) and 42 months (IQR 21–62). Wound complications were common in O-ILND group (65.6%) compared to VEIL group (27.7%) (p = 0.001), predominantly skin flap necrosis in 14 groins (23.73%) after O-ILND and none after VEIL. Median overall survival was 80 and 88 months (p = 0.840) with five-year survival of 65% and 66.8% (p = 0.636) and five-year DSS of 76.6% and 73.9% (p = 0.96) in O-ILND and VEIL, respectively. Multivariate analysis showed that grade and pathological node status were significant (HR-2.650, p = 0.040; HR-3.218, p = 0.024) factors for survival. The retrospective nature of the study design is the limitation. Management of inguinal lymph nodes in carcinoma penis by VEIL is safe, associated with lesser wound-related complications, and equivalent survival outcomes compared to O-ILND. It should be considered as an alternative option for inguinal lymph node dissection. [ABSTRACT FROM AUTHOR]

Introduction: Reconstruction surgeries of the inguinal area pose a challenge for oncological and orthopedic surgeons, especially after radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both. Although numerous surgical procedures have been reported, there is no report about a pedicle adductor longus flap method. The aim of this work is to show our experience about inguinal reconstruction with pedicled adductor longus flap and associated outcomes.Patients and Methods: A retrospective study of 16 patients with localized inguinal region interventions and reconstructed by adductor longus flap from March 2016 to July 2020. Patients' average age was 60.0 years (range = 38–79 years) and had postoperative follow-up of 10 months (ranging 2–19 months). All patients had unilateral inguinal region involvement—seven cases on the left and nine cases on the right. The patients' clinical course, operative course, and postoperative follow-up data were evaluated.Results: All 16 patients recovered well post-operatively and did not require any re-intervention. Four patients experienced negligible discomfort around the groin area. Five patients experienced a minor strength deficit in thigh adduction compared with that of preoperative strength in the same or contralateral leg. The aforementioned complications resolved during the postoperative course and had no functional impact on their activity of daily living. All adductor longus flaps survived, completely filled the inguinal dead space, and wounds healed uneventfully within 3 weeks except for three patients who suffered delayed wound healing for more than 4 weeks. Other common complications such as infection, seroma, or wound dehiscence were not encountered in this series.Conclusion: The adductor longus flap is a reliable alternative method for inguinal region reconstruction following radical local resection (RLR), radical inguinal lymph node dissection (RILND), or both.

A 78-year-old man presented with lymphatic fluid collections in bilateral inguinal area after bilateral inguinal lymph node dissections. Because no inguinal or popliteal lymph nodes were observed under ultrasound examination, intranodal lymphangiography was not applicable. Although traditional pedal lymphangiography was required, it was difficult to perform this procedure owing to the decreasing frequency over the past 20 years and being unavailable in not only our institution, but also other in institutions. Therefore, we performed catheterization using the 29-guage Argyle PI catheter into the lymphatic duct in lower legs under a microscope and achieved successful percutaneous embolization using N-butyl cyanoacrylate for inguinal lymphatic leakage.

Anatomy of the lymphatic drainage guides the extent of inguinal lymph node dissection in penile cancer. To prospectively assess the lymphatic drainage of penile cancer with single-photon emission computed tomography CT (SPECT-CT) and implications for the extent of inguinal lymph node dissection. We assessed the lymphatic drainage of 62 patients with at least unilateral clinical lymph node-negative (cN0) status with SPECT-CT at our tertiary referral centre. We evaluated 122 cN0 inguinal basins and compared them to the histopathological outcome. The inguinal regions were divided into ten different Daseler zones on SPECT-CT. The surgical team filled in a corresponding scheme at sentinel node biopsy and sent lymph nodes from each Daseler zone individually for histopathological examination. SPECT-CT successfully visualized lymphatic drainage in 116 of the 122 cN0 inguinal basins (95.1%). The vast majority of sentinel nodes and all metastatic nodes were located in central and superior inguinal zones, including six metastatic nodes in lateral superior zones. Minimal lymphatic drainage was seen to the inferior Daseler zones and no metastatic deposits were located here. No direct pelvic drainage was observed. Penile cancer lymphatic drainage is primarily to sentinel in the superior and central zones of Daseler. Colleagues practicing a modified inguinal lymph node dissection as a standard in cN0 patients are encouraged to include all these zones, while the inferior zones can be omitted. This study confirms the absence of lymphatic drainage directly to the pelvic region and supports the practice of omitting pelvic nodes from sentinel node biopsy. [ABSTRACT FROM AUTHOR]

Abstract Background The 8th edition of the tumor-node-metastasis (TNM) classification classifies inguinal lymph nodes as regional lymph nodes for anal canal carcinoma but non-regional lymph nodes for rectal carcinoma. This difference might reflect the different prognosis of inguinal lymph node metastasis from anal canal carcinoma and rectal carcinoma. However, long-term outcomes of inguinal lymph node metastasis from rectal or anal canal adenocarcinoma are unclear, which we aimed to investigate in this study. Methods The study population included 31 consecutive patients with rectal or anal canal adenocarcinoma who underwent inguinal lymph node dissection with curative intent at the National Cancer Center Hospital from 1986 to 2017. Long-term outcomes were assessed and clinicopathologic variables analyzed for prognostic significance. Results Of the 31 patients, 12 patients had rectal adenocarcinoma and 19 patients had anal canal adenocarcinoma. Synchronous metastasis were observed in 14 patients and metachronous metastasis in 17 patients. After dissection of inguinal lymph node metastasis with curative intent, the 5-year overall survival rate was 55.2%, with 12 patients surviving for more than 5 years. Median survival time was 66.6 months. Multivariate analyses revealed that location of primary tumor (rectum versus anal canal) was not a prognostic factor, whereas lateral lymph node metastasis and histological findings were independent prognostic factors. Conclusion Given the good prognosis, inguinal lymph node metastasis in patients with rectal or anal canal adenocarcinoma appears to be regional rather than distant. If R0 resection can be achieved, inguinal lymph node dissection may be indicated for these patients.

A 65-year-old male presented with progressive swelling and difficulty in walking due to a right foot sprain. Initial treatments were conducted in Chandrapur, followed by referral to Acharya Vinoba Bhave Rural Hospital for further evaluation and management. The patient, a known case of diabetes mellitus and hypertension, reported an insidious onset of right foot swelling over two months. A physical examination revealed stable vital signs; no significant abnormalities were observed during the systemic examination. Laboratory investigations indicated mild anemia and slightly elevated liver enzymes. Imaging studies, including MRI and CT scan, identified an ill-defined lesion on the medial aspect of the right foot, consistent with dermatofibroma. The patient underwent a below-knee amputation with inguinal lymph node dissection on 31st May 2024. The procedure, performed under spinal and epidural anesthesia, involved meticulous dissection and ligation, with the posterior flap sutured using Ethilon 2-0 (Ethicon, Cincinnati, OH, USA). Post-operative management included IV antibiotics and supportive care. The patient's postoperative course was uneventful, with a healthy suture line and stable vitals upon discharge. Histopathological evaluation of the resected specimen confirmed melanoma, with immunohistochemistry revealing HMB-45 and S-100 negativity. The patient was discharged with advice on local hygiene, physiotherapy, dietary recommendations, and a follow-up schedule. This case highlights the importance of comprehensive multidisciplinary management in treating malignancies complicated by chronic conditions. Early diagnosis, appropriate surgical intervention, and diligent post-operative care are crucial for favorable outcomes in complex oncological cases., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Bhatnagar et al.)

Objective To compare the clinical effect of laparoscopic inguinal lymph node dissection versus open surgery for penile cancer, and to explore the feasibility of laparoscopic inguinal lymph node dissection. Methods We retrospectively analyzed the data of 84 penile cancer patients who underwent inguinal lymph node dissection. Patients were divided into open group and laparoscopic group according to the surgical method of lymph node dissection. The preoperative data, intraoperative parameters, postoperative complications and efficacy of the two groups were analyzed. Results There was no statistically significant difference in age, clinical tumor stage, lymph node size, the operative time, the number of lymph nodes dissected or intraoperative blood loss between the laparoscopic group and the open group (P > 0.05). But in terms of postoperative hospital stay, skin flap necrosis and postoperative incision infection rate, the incidence of postoperative lymphatic fistula, etc., there was statistical difference between the two groups (P < 0.05). Postoperative follow-up was 3 months to 2 years, in which 2 patients in the laparoscopic group recurred, while 3 patients in the open group relapsed, with no death and no statistically significant difference between the both groups (P > 0.05). Conclusion Compared with open surgery, laparoscopic inguinal lymphadenectomy could obtain the same clinical curative effect, but with less trauma and postoperative complications.

Anal SCC is a rare disease mainly treated with chemoradiation. Abdominoperineal resection (APR), once the mainstay of treatment for anal cancer, now serves a role as salvage therapy for persistent or recurrent disease after chemoradiation. In addition, clinically positive nodes are currently treated by extending the radiation field to the groin. The role of inguinal lymph node dissection in recurrent or persistent anal SCC is unclear. The aim of the study is to determine the role of inguinal lymph node dissection in the management of inguinal lymph node metastasis for anal squamous cell carcinoma (SCC). Retrospective analysis of patients with anal SCC in the National Cancer Database with positive inguinal nodes undergoing salvage APR between 2004 and 2014 was performed. A comparison of overall survival between patients who underwent APR with lymph node dissection versus APR only was analyzed using Kaplan-Meier plot. A total of 3424 patients underwent salvage APR, with 274 (8%) having clinically positive nodes. Within the subgroup that had clinically positive nodes, 195 (71%) underwent APR, whereas 79 (29%) underwent both APR and node dissection. Kaplan-Meier analysis demonstrates no difference in overall survival in the two groups (P = 0.99). Five-year survival for both groups was similar (36% versus 42%; P = 0.987). No significant difference was found when adjusted for age, gender, and Tumor Node Metastasis staging. Inguinal lymph node dissection does not appear to improve overall survival in patients with advanced-stage anal cancer requiring salvage APR. Proper patient selection for node dissection is essential to spare patients from additional morbid procedures. [ABSTRACT FROM AUTHOR]

• Robotic assisted inguinal lymph node dissection (RAIL) is an evolving operative strategy for the management of the inguinal region in patients with penile squamous cell carcinoma especially in the setting of clinically negative inguinal nodes (cN0). • In a cN0 setting, oncologic outcomes were similar between open superficial inguinal lymph node dissection (OSILND) and RAIL. • RAIL was associated with longer operative time, longer post-operative drain duration, and similar postoperative complication rates compared to OSILND. • Overall, RAIL is a reliable staging and potentially therapeutic procedure among cN0 patients with penile squamous cell carcinoma with comparable outcomes to an OSILND cohort. To evaluate perioperative and oncologic outcomes of a cohort of clinically node negative high-risk penile cancer patients undergoing robotic assisted inguinal lymph node dissection (RAIL) compared to patients undergoing open superficial inguinal lymph node dissection (OSILND). We retrospectively reviewed the clinical characteristics and outcomes of clinically node negative high-risk penile cancer patients undergoing RAIL at MDACC from 2013-2019. We sought to compare this to a contemporary open cohort of clinically node negative patients treated from 1999 to 2019 at MDACC and Moffit Cancer Center (MCC) with an OSILND. Descriptive statistics were used to characterize the study cohorts. Comparison analysis between operative variables was performed using Fisher's exact test and Wilcoxon's rank-sum test. The Kaplan-Meier method was used to estimate survival endpoints. There were 24 patients in the RAIL cohort, and 35 in the OSILND cohort. Among the surgical variables, operative time (348.5 minutes vs. 239.0 minutes, P < 0.01) and the duration of operative drain (37 vs. 22 days P = 0.017) were both significantly longer in the RAIL cohort. Complication incidences were similar for both cohorts (34.3% for OSILND vs. 33.3% for RAIL), with wound complications making up 33% of all complications for RAIL and 31% of complications for OSILND. No inguinal recurrences were noted in either cohort. The median follow-up was 40 months for RAIL and 33 months for OSILND. We observed similar complication rates and surgical variable outcomes in our analysis apart from operative time and operative drain duration. Oncological outcomes were similar between the two cohorts. RAIL was a reliable staging and potentially therapeutic procedure among clinically node negative patients with penile squamous cell carcinoma with comparable outcomes to an OSILND cohort. [ABSTRACT FROM AUTHOR]

Abstract Background Inguinal lymph node dissection (LND) is a surgical procedure with a high morbidity rate. Variations in surgical procedure, such as sparing of the saphenous vein, have been proposed to reduce surgical morbidity. While sparing of the saphenous vein has shown promising results in earlier studies, data for this procedure in melanoma patients are rare. In this retrospective study, we report 10-year findings on the effects of saphenous vein-sparing LND on surgical morbidity and oncologic outcomes in melanoma patients. Methods A retrospective analysis of melanoma patients receiving inguinal LND in our facility between 2003 and 2013 was performed. Patients were divided into two groups: the saphenous vein resection group and the vein sparing group. Surgical morbidity, including wound infection, lymphatic fistula, severe bleeding, neurological complications, and chronic lymphedema, as well as regional recurrence-free survival were investigated. Results A total of 106 patients were included in this study; of these, the saphenous vein was spared in 41 patients (38.7%). The rate of lymphatic fistula was 51.6 vs. 48.8%, wound infection occurred in 31.3 vs. 24.4%, and patients suffered from chronic lymphedema in 30.0 vs. 26.5% in V. saphena magna resection vs. sparing group. Differences observed, however, were not significant. No difference in regional recurrence-free survival between the two study groups was detected. Conclusions The results of our retrospective analysis could not confirm the promising results reported in earlier studies. Thus, sparing of the saphenous vein appears to be optional.