[Indications for selective lymphadenectomy and systematic axillary, inguinal and iliac lymph node dissection]

Area of Science:

• Oncology
• Surgical Pathology
• Lymphedema Research

Context:

• Lymphadenectomy is a surgical procedure involving lymph node resection, primarily for oncological treatment of various malignancies.
• Includes carcinomas (breast, penis, vulva, anus), malignant melanomas, and sarcomas.
• Distinguishes between regional lymph node removal, sentinel lymph node biopsy, and radical lymphadenectomy.

Purpose:

• To review the current status of lymphadenectomy based on German guidelines, anatomical knowledge, and specific indications.
• To provide an overview of vascularized lymph node transfer for reconstructive purposes in lymphedema.
• To highlight the advantages of sentinel lymph node dissection in reducing morbidities and improving patient quality of life.

Summary:

• Sentinel lymph node dissection, a less invasive approach, has significantly reduced the need for radical lymphadenectomy, thereby mitigating severe morbidities.
• This strategy spares lymphatic drainage pathways, leading to decreased lymphedema, inflammation, and wound healing complications.
• Lymphadenectomy also serves palliative roles, and vascularized lymph node transplantation is utilized for reconstructive lymphedema treatment.

Impact:

• Improved patient quality of life through reduced lymphedema and other complications associated with radical lymphadenectomy.
• Advancement in oncological surgical treatment strategies by prioritizing less invasive techniques like sentinel lymph node dissection.
• Enhanced understanding and application of lymph node grafting techniques for managing lymphedema.