title: A prospective, randomized study analyzing sartorius transposition following inguinal-femoral lymphadenectomy.
abstract: 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.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics, Gynecology, and Women's Health, University of Minnesota, Minneapolis, MN 55455, USA. judso003@umn.edu
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Judson
authors.forename: Amy L
authors.initials: AL
authors.lastname: Jonson
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Paley
authors.forename: Robin L
authors.initials: RL
authors.lastname: Bliss
authors.forename: Karuna P
authors.initials: KP
authors.lastname: Murray
authors.forename: Levi S
authors.initials: LS
authors.lastname: Downs
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Boente
authors.forename: Peter A
authors.initials: PA
authors.lastname: Argenta
authors.forename: Linda F
authors.initials: LF
authors.lastname: Carson
mesh_terms: 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*