A prospective, randomized study analyzing sartorius transposition following inguinal-femoral lymphadenectomy.
OBJECTIVE
Based on the reduced morbidity seen in our retrospective study, we undertook a prospective, randomized trial to determine whether transposition of the sartorius muscle improves post-operative morbidity in women with squamous cell carcinoma of the vulva undergoing inguinal-femoral lymphadenectomy.


METHODS
Patients with squamous carcinoma of the vulva requiring inguinal-femoral lymphadenectomy were randomized to undergo sartorius transposition or not. All patients received perioperative antibiotics, DVT prophylaxis, and closed suction surgical site drainage. Outcomes assessed include wound cellulitis, wound breakdown, lymphocyst formation, lymphedema, and/or rehospitalization. Cohorts were compared using Fisher's exact test. Baseline characteristics were compared using Student's t test or Fischer's exact test as appropriate. Logistic regression was used to assess the impact of sartorius transposition, after adjusting for other factors.


RESULTS
From June 1996 to December 2002, 61 patients underwent 99 inguinal-femoral lymphadenectomies, 28 with sartorius transposition, and 33 without. The mean (SD) age for controls and patients undergoing sartorius transposition was 63.5 (15.2) and 73.8 (13.7) years, respectively (P < 0.05). There were no statistically significant differences in BSA, tobacco use, co-morbid medical conditions, past surgical history, medication use, size of incision, duration of surgery, number of positive lymph nodes, pathologic stage, pathologic grade, pre- or postoperative hemoglobin, or length of hospitalization. There were no statistically significant differences in the incidence of wound cellulitis, wound breakdown, lymphedema, or rehospitalization. The incidence of lymphocyst formation was increased in the sartorius transposition group. After adjusting for age, however, the groups appeared similar.


CONCLUSIONS
Sartorius transposition after inguinal-femoral lymphadenectomy does not reduce postoperative wound morbidity.
Judson
Patricia L
PL
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN 55455, USA. judso003@umn.edu
Jonson
Amy L
AL
Paley
Pamela J
PJ
Bliss
Robin L
RL
Murray
Karuna P
KP
Downs
Levi S
LS
Boente
Matthew P
MP
Argenta
Peter A
PA
Carson
Linda F
LF
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D007264:Inguinal Canal / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000601:surgery*; D011446:Prospective Studies; D014846:Vulvar Neoplasms / Q000601:surgery*