EP385/#1176 Implementation of a modified medial inguinofemoral groin dissection technique to reduce morbidity in vulval cancer surgery: an UK- India experience. (4th December 2022)

• Record Type: Journal Article
• Authors: Mukhopadhyay, Asima
• Is Part Of: International journal of gynecological cancer. Volume 32(2022)Supplement 3
• Page Start: A210
• Page End: A210
• Publication Date: 2022-12-04
• Subjects: Generative organs, Female -- Cancer -- Periodicals; 616.99465
• DOI: 10.1136/ijgc-2022-igcs.474
• Languages: English
• ISSNs: 1048-891X

Abstract

Abstract : Objectives: Traditional Groin node dissection techniques are associated with significant local wound related morbidity and lymphedema. Sentinel node techniques are not available widely in many LMICs and are not applicable due to tumour size at presentation or multifocal disease. Novel techniques for morbidity reduction and training is required for implementation. Methods: A technique was developed comprising of the following: Small incision above groin crease- 1 cm lateral to pubic tubercle not extending beyond pulsation of femoral artery, Saphenous-sparing, Subfasial dissection, Closure of subcutanous fat in 2 layers to obliterate dead space, suction drains to stay according to output, early ambulatory care. Success was measured using: Would complication rates- breakdown/lymphedema, Vulval QOL, Surgeon's/trainee satisfaction, implementation as a new standard of care, pathology, groin recurrence. Results: Since June 2019, this technique was implementated in 3 centres: 1.NGOC, Gateshead, UK 2. JCUH, Middlesbrough UK 3. CNCI, Kolkata, India Both RCOG subspeciality fellows and IGCS fellows ( India/Nepal) were trained. > 25 cases have been performed. Trainees found this technique easy to learn/implement. It has been a regarded as a change of practice in all 3 institutions including plan for surgical QA . Average length of incision was 5–6 cm without compromising depth of dissection, removal of nodes medial to femoral artery/vein and visibility of the femoral triangle. There was significant reduction in local wound-related morbidity. In CNCI Kolkata, IGCS fellow has started audit on QOL . No groin recurrences have been detected till date. Conclusions: Surgical techniques to reduce morbidity in cancer surgery is a priority