J Gynecol Oncol.  2015 Oct;26(4):320-326. 10.3802/jgo.2015.26.4.320.

Clinical application of sartorius tendon transposition during radical vulvectomy: a case control study of 58 cases at a single institution

• Li L
• Kou X
• Feng X
• Liu F
• Chao H
• Wang L

• KMID: 2345923
• DOI: http://doi.org/10.3802/jgo.2015.26.4.320

Abstract

OBJECTIVE
The aim of this study was to investigate the clinical effects of sartorius tendon transposition versus sartorius transposition during bilateral inguinal lymphadenectomy of radical vulvectomy.
METHODS
A total of 58 vulvar cancer patients who had surgery from May 2007 to October 2013, in which 30 patients received sartorius transposition and 28 patients received sartorius tendon transposition. All patients were matched by age, body mass index, stage, histology, and grade. Intraoperative variables and postoperative complications, recurrence, progression-free survival (PFS), and overall survival (OS) and postoperative life quality were compared and analyzed.
RESULTS
No significant differences were found at median surgical times and amounts of bleeding (p=0.316 and p=0.249, respectively), neither at the incidences of groin cellulitis and lymphocele (p=0.673 and p=0.473, respectively), but the recovery times of the inguinal wounds were shorter (p=0.026) and the incidences of wound break and chronic lymphedema were significantly decreased in the tendon transposition group (p=0.012 and p=0.022, respectively). Postoperative quality of life in tendon transposition group was significantly improved as indicated by the EORTC QLQ-C30 questionnaire. Recurrences were similar (p=0.346) and no significant differences were found at PFS and OS (p=0.990 and p=0.683, respectively).
CONCLUSION
Compared to sartorius transposition, sartorius tendon transposition during inguinal lymphadenectomy led to improved patient recovery, reduced postoperative complications, and improved life quality without compromising the outcomes.

Keyword

Bilateral Inguinal Lymphadenectomy; Radical Vulvectomy; Sartorius Transposition; Vulvar Carcinoma

MeSH Terms

Case-Control Studies
Female
Follow-Up Studies
Humans
Lymph Node Excision/*methods
Lymphatic Metastasis
Organ Sparing Treatments/methods
Surgical Flaps
Surgical Wound Infection/etiology
Tendons/*transplantation
Vulva/*surgery
Vulvar Neoplasms/*surgery

Figure

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  Fig. 1 The membrane of the sartorius tendon was cut from the surface of the sartorius at its attachment points and freed for approximately 5 cm.

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  Fig. 2 The membrane of the sartorius tendon was transposed and sutured to the inguinal ligament.

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  Fig. 3 Kaplan-Meier survival curves for the (A) progression-free survival (PFS) and (B) overall survival (OS) of the patients. No significance differences in PFS (p=0.990) or OS (p=0.683) were found.

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