Key factors in reducing morbidity following inguinal node dissections

Background Inguinal node dissection is associated with high incidence of post-operative morbidity. Methods We conducted a retrospective review of all patients who underwent inguinal node dissection at The Christie Hospital between 2001 and 2008. Two hundred thirty two patients undergoing 247 inguinal node dissection outcomes were assessed with a median follow-up of 29 months (range 5 to 75). Results Our overall complication rate was 61 %. Our wound infection rate is 34 % with 10 % wound necrosis, 25 % wound breakdown, 35 % seroma, 23 % lymphoedema and 0.4 % haematoma rate. The overall and individual complication rate, including infection wound breakdown, skin necrosis, seroma formation and lymphoedema, was significantly lower with use of a transverse incision for access compared to using a Lazy S and longitudinal incisions ( P < 0.008 and P < 0.0001, respectively). Patients undergoing Sartorius switch had a reduced rate of seroma formation ( P = 0.018). The preservation of the long saphenous veins was also associated with a reduction on the overall complication rate ( P = 0.007). Conclusions Inguinal node dissection postoperative complications are reduced by transverse incision, Sartorius switch and preservation of the long saphenous vein. Level of Evidence: Level IV, prognostic/risk study.