title: Modified radical vulvectomy without lymphadenectomy under local anesthesia in medically compromised patients.
abstract: BACKGROUND
  Our objective was to review our experience with vulvar cancer treated with modified radical vulvectomy without lymphadenectomy under local anesthesia and sedation.
  
  
  METHODS
  A retrospective review of surgical case lists revealed five patients who underwent modified radical vulvectomy without lymphadenectomy under local anesthesia with sedation. All patients had significant medical diseases which precluded regional or general anesthesia. Modified radical vulvectomy was performed in standard fashion under sedation and local anesthesia. Inguinal lymphadenectomy was not performed.
  
  
  RESULTS
  Median operative time was 1.5 h and median blood loss was 100 cc. Median diameter of tissue resected was 5 cm and median depth was 5 cm. Median length of hospital stay was 4 days. No patient complained of pain during the operative procedure. At a median follow-up of 2.5 years, there has been one local recurrence.
  
  
  CONCLUSIONS
  Five patients with symptomatic vulvar cancer who were not candidates for regional or general anesthesia underwent modified radical vulvectomy without lymphadenectomy under local anesthesia with sedation. The procedure was well-tolerated and produced minimal morbidity and adequate short-term local control.
authors.affiliation: Division of Gynecologic Oncology, Medical College of Ohio, Toledo, Ohio 43614, USA.
authors.forename: K J
authors.initials: KJ
authors.lastname: Manahan
authors.forename: J
authors.initials: J
authors.lastname: Hudec
authors.forename: J
authors.initials: J
authors.lastname: Fanning
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D012189:Retrospective Studies; D014844:Vulva / Q000601:surgery*; D014846:Vulvar Neoplasms / Q000601:surgery*