Saphenous vein-preservation technique: the no more complications after inguinal lymph-node dissection

Background
The upper part of the saphenous vein is removed in traditional inguinal lymph-node dissection. We believe that maintaining the saphenous vein during inguinal lymphadenectomy would reduce morbidity without compromising the oncological safety.
Introduction
The main step in the management of metastatic cancer involving the inguinal lymph node is inguinal lymph-node dissection, but this surgical method is accompanied with postoperative morbidity. The common surgical complications are wound dehiscence and lymphedema, and lowering the rate of their occurrence improves the patient’s quality of life.
Aim
To evaluate saphenous vein-preservation technique during modified inguinal lymph-node dissection as regarding postoperative short-term and long-term complications.
Patients and methods
A prospective study of 53 patients with metastatic carcinoma to inguinal lymph node who underwent inguinal lymph-node dissection between January 2017 and January 2021 at the Surgery Department, Menoufia University Hospital, Egypt. Short-term and long-term postoperative complications were assessed.
Results
About 53 patients underwent 61 inguinal lymph-node dissections. In 58 patients, the saphenous vein was maintained. Cellulitis occurred in 12% of the patients, thrombophlebitis occurred in 5.1%, hematoma occurred in 3.4%, seroma occurred in 3.4%, deep-vein thrombosis occurred in 1.7%, and partial wound dehiscence occurred in 1.7%. Lymphedema occurred in 20.6% in the first 3 months, in 8.6% after 6 months postoperatively. Chronic lymphedema (12 months) was present in only 1.7% of the patients and disappeared completely in 18 months postoperatively. There is no locoregional tumor recurrence.
Conclusions
The technique of the saphenous vein-preservation strategy during inguinal lymph-node dissections minimizes both short-term and long-term postoperative problems while maintaining oncological safety outcome.
Recommendation
In patients undergoing inguinal lymph-node dissection, the saphenous vein is better preserved.