Radical inguinal lymphadenectomy

Eradication of inguinal lymphadenectomy is a surgical procedure to completely remove the inguinal lymph and avoid lymphatic metastasis of the intra-abdominal tumor. Treatment of diseases: vulvar invasive squamous cell carcinoma Indication 1. Vulvar invasive squamous cell carcinoma infiltration depth > 1mm (vulnerary cancer stage Ib or more), or vascular infiltration, or clinical suspected inguinal lymph node metastasis, should be unilateral bilateral inguinal lymphadenectomy. 2. Vulvar invasive adenocarcinoma, or malignant melanoma clinical suspicious lymph node metastasis, or malignant melanoma lesion depth > 0.75mm, should be bilateral inguinal lymphadenectomy. 3. Vulvar cancer involves the urethra and vaginal opening 1~2cm. Most of the anus is affected by lymphatic involvement. It should be treated with bilateral inguinal lymph node dissection. 4. In other parts of the cancer (endometrial cancer, ovarian cancer), the primary cancer has been resected, and the inguinal lymph node metastasis is the only residual cancer, which can be used for inguinal lymph node resection (sweeping/sampling). Contraindications 1. A serious medical disorder in the body cannot be operated. 2. The pubis has been affected or has distant metastasis. 3. Inguinal lymph node metastasis can not be removed. Preoperative preparation Antibiotics are routinely used before surgery. Surgical procedure 1. Supine, split legs or low bladder lithotomy position, thigh micro-external rotation, expose the groin and femoral triangle, disinfection, cover. 2. Make an 8~10cm incision along the medial aspect of the anterior superior iliac spine (longitudinal incision or transverse arc incision along the groin. Longitudinal incision: 2cm inside the anterior superior iliac spine down the 1/3 of the medial groin). Incision: inward of the inguinal tendon along the groin). Cut the skin subcutaneously 3~4mm deep. 3. along the external oblique muscle aponeurosis, from the outside to the inside, from the top to the lower part of the inguinal lymphoid tissue, concentrated in the triangle. 4. Cut and double ligature the saphenous vein above the deep fascia at the top of the thigh triangle (inside and below); cut and ligature the superficial vein branches around the lymphatic fat pad of the femoral triangle. 5. Cut the medial aponeurosis of the sartorius muscle, and separate the femoral blood vessels and the triad lymph and adipose tissue from the outside to the inside. If you need to clean the deep lymph nodes, you can cut the femoral sheath. 6. Severe, double ligament external genital veins, cut off, double ligation of the great saphenous vein into the femoral vein. 7. Free lymphatic tissue around the free blood vessels, along the medial side of the femoral vein, under the inguinal band, etc., remove the inguinal deep lymph nodes (cloguet's) and send frozen pathological examination. 8. Remove all inguinal lymphatic fat pads and concentrate them on the palsy, and remove or leave the vulva for extensive resection. 9. Hemostasis, flushing, suturing the fascia defect at the femoral triangle to cover the femoral blood vessels; or free sartorius muscle, fixed on the inguinal band to cover the femoral vessels at the femoral triangle. 10. Discharge, suture the skin, skin.