关键词: 外阴癌, 腹股沟淋巴结切除, 适应证

Abstract:

Vulva radical local excision and inguinofemoral lymphadenectomy are the standard surgical approach to vulva cancer.FIGO and NCCN guidelines recommend that groin dissection is not necessary for Stage ⅠA carcinoma of the vulva and all patients with FIGO stageⅠB or stageⅡlesions should have an inguinofemoral lymphadenectomy.It is desirable to determine the status of the groin nodes prior to planning the overall treatment for advanced vulvar cancer.If there are no suspicious nodes before surgery，bilateral inguinofemoral lymphadenectomy may be performed.If nodes are clinically positive，a complete lymphadenectomy should be avoided.Only enlarged nodes from the groin and pelvis should be removed if feasible，and the patient is given postoperative groin and pelvic radiation.There are some controversies about lymph node resection.Most scholars reach consensus on the such controversial issues as both inguinal and femoral nodes removal，groin dissection performed through a triple incision approach，groin dissection performed through a transverse incision approach，and the preservation of the saphenous vein.The need to perform bilateral lymphadenectomy for midline primary tumors not invading midline structures and the operation indication of inguinofemoral lymphadenectomy for bartholin gland carcinoma and melanoma remain to be investigated.

Key words: vulva cancer, groin lymphnode dissection, indication