Infectious Morbidity After Radical Vulvectomy

[摘要] Objective:This retrospective investigation describes the infectious morbidity of patients followingradical vulvectomy with or without inguinal lymph node dissection.Methods:The charts of patients undergoing radical vulvectomy between January 1, 1986, andSeptember 1, 1989, were reviewed for age, weight, cancer type, tumor stage, operative procedure(s), prophylactic antibiotic and its length of use, febrile morbidity, infection site, culture results, significant medical history, and lengthof use and number of drains or catheters used.Results:The study group was composed of 61 patients, 14 of whom underwent a radical vulvectomyand 47 who also had inguinal lymph node dissection performed. Twenty-nine patients (48%) had at least 1 postoperative infection. Five patients (8%) had 2 or more postoperative infections. The site and incidence of theinfections were as follows: urinary tract 23%, wound 23%, lymphocyst 3%, lymphatics (lymphangitis)5%, and bowel (pseudomembranous colitis) 3%. The most common pathogens isolated from both urine andwound sites werePseudomonas aeruginosa, enterococcus, andEscherichia coli.A significant decrease in wound infection was demonstrated when separate incisions were made for inguinal lymph node dissection (P<0.05). The mean number of days to onset of postoperative infection for wound, urine, lymphatics, lymphocyst, and bowel were11, 8, 57, 48, and 5, respectively.Conclusions:We conclude that the clinical appearance of post-radical vulvectomy infections isdelayed when compared with other post-surgical wound infections. Second, utilizing separate inguinal surgicalincisions may reduce infectious morbidity. Finally, tumor stage and type do not necessarily increase the infectiousmorbidity of radical vulvar surgery.

[学科分类] 妇产科学