title: Morbidity of selective lymph node biopsy  for melanoma: meta-analysis of complications.
abstract: OBJECTIVE
  Intraoperative lymphatic mapping and selective lymph node biopsy is accepted worldwide as the standard procedure for staging regional lymph nodes of 1-4 mm thick melanomas, as well as for other neoplasms. Although it is often stated that selective lymph node biopsy is a minimally invasive procedure associated with few complications, few data exist concerning the morbidity associated with the procedure. The present analysis was performed to evaluate the morbidity associated with selective lymph node biopsy in a long-term follow-up.
  
  
  METHODS
  The study provides a review of 437 selective lymph node biopsies on 269 patients, operated on between the 1994 and the 2009, for the lymph node biopsy of head and neck, groin, axilla, upper and lower limbs and nodal basins. Patients' history and follow-up were reviewed for 2 weeks after surgery, every 3 months for the first 2 years, every 4 months during the third year, and every 6 months subsequently, and postoperative morbidity was evaluated.
  
  
  RESULTS
  After sentinel node biopsy, 14 patients developed one of the following complications: hematoma, 1 case (0.30%); lymphedema, 1 case (0.30%); seroma, 2 cases (0.61%); wound infection, 6 cases (1.83%); keloid scar, 2 cases (0.61%); and postoperative pain, 2 cases (0.61%). The total complication rate was 4.26%.
  
  
  CONCLUSIONS
  Selective lymph node biopsy for melanoma, as for other tumors, in respect to radical lymphadenectomy, is not a complications-free procedure but is usually not severe.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Sapienza University of Rome, Rome, Italy. emanuelecigna@msn.com
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cigna
authors.forename: Angela
authors.initials: A
authors.lastname: Gradilone
authors.forename: Diego
authors.initials: D
authors.lastname: Ribuffo
authors.forename: Paola
authors.initials: P
authors.lastname: Gazzaniga
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fino
authors.forename: Valentina
authors.initials: V
authors.lastname: Sorvillo
authors.forename: Nicolò
authors.initials: N
authors.lastname: Scuderi
mesh_terms: D001365:Axilla; D005500:Follow-Up Studies; D006119:Groin; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007627:Keloid / Q000209:etiology; D035002:Lower Extremity; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery*; D008207:Lymphatic Metastasis; D008209:Lymphedema / Q000209:etiology; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D009017:Morbidity; D009333:Neck; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000209:etiology; D021701:Sentinel Lymph Node Biopsy / Q000009:adverse effects*; D049291:Seroma / Q000209:etiology; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D034941:Upper Extremity