Didactics-Decreasing incidence of lower limb lymphoedema

Decreasing incidence of lower limb lymphoedema_Nevill Hacker Feb 2022.mp4

Video Transcription

Video Summary

In this video, Professor Hacker discusses the issue of lower limb lymphedema in patients with vulva cancer. He explains that removing lymph nodes during inguinal femoral lymph node dissection is the only way to determine the status of groin nodes, but it often leads to lymphedema in 40-60% of patients. Hacker goes on to discuss past attempts to reduce the risk of lymphedema, including defining a category of microinvasive cancer and treating groins with radiation. None of these approaches were successful. He then introduces two potential solutions. The first is using sentinel node biopsy and serial groin ultrasonography for patients with negative sentinel nodes, which he believes should be the treatment of choice for small tumors. The second solution is medial inguinal femoral lymphadenectomy, which involves removing only the lymph nodes located medially and leaving the lateral nodes intact if the medial nodes are negative. Hacker suggests that this approach could decrease the incidence and severity of lymphedema without compromising survival. He concludes by stating that further investigation is needed for both approaches. No credits were given in the video.

Keywords

lower limb lymphedema

vulva cancer

lymph node dissection

inguinal femoral lymphadenectomy

sentinel node biopsy

medial inguinal femoral lymphadenectomy