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Predictors of complication after groin dissection: a single-centre experience
Ghader Jamjoum1, Thea Araji1, Diana Nguyen1
1From Gerald Bronfman Department of Oncology (Jamjoum) McGill University, Montréal, Que. (Jamjoum); Department of Surgery (Jamjoum), King Abdul-Aziz University, Jeddah, Saudi Arabia; Faculty of Medicine and Health Sciences (Araji), McGill University, Montréal, Que.; McGill University Health Centre Research Institute (Nguyen, Meguerditchian), Montréal, Que.; Department of Surgery (Meguerditchian), McGill University, Montréal, Que.; St. Mary's Research Centre (Meguerditchian), Montréal, Que.
Background:
Inguinal lymphadenectomy (ILND) has historically been associated with substantial morbidity. The objective of this study was to obtain contemporary ILND morbidity rates and to identify potentially preventable risk factors.
Methods:
We carried out a retrospective review of medical records for all superficial, deep, and combination groin dissections performed at a single, high-volume academic centre between January 2007 and December 2020. We collected data points for patient, disease, and surgery characteristics, and cancer outcomes. The outcome of interest was any complication within 30 days of surgery. Complications included wound infection, wound necrosis or disruption, seroma, drainage procedure, hematoma, and lymphedema. We performed multivariate logistic regression using SAS version 9.4.
Results:
We identified 139 patients having undergone 89 superficial, 12 deep, and 38 combined dissection types, respectively. Melanoma accounted for 84.9% of cases. Of these patients, 56.1% had an adverse postoperative event within 30 days. Increasing age (odds ratio [OR] 1.04, 95% confidence interval [CI] 1.01-1.07, p < 0.01) and number of positive lymph nodes harvested (OR 1.22, 95% CI 1.00-1.50, p = 0.05) were associated with more complications. Patients with deep dissection showed a lower likelihood of complications than those with superficial dissection (OR 0.15, 95% CI 0.03-0.84, p < 0.05).
Conclusion:
Complication rates after ILND remain high. We identified a number of risk factors, providing opportunities for better selection and prevention.
