Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men) who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity. 1. Introduction Regional lymph node dissection is the standard treatment regimen for patients with sentinel lymph node biopsy (SLNB) positive melanoma or clinically evident palpable lymph node metastasis of the disease. Inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. Wound complication rates up to 71% have been reported, including hematoma, seroma, skin necrosis, wound infection, and wound dehiscence [1]. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life [2]. Many techniques have been reported to reduce postoperative lymphedema, such as preserving the muscle fascia [3], pedicled omentoplasty [4], sartorius transposition [5], and saphenous vein sparing inguinal lymphadenectomy [6]. The reported studies on sparing the saphenous vein in inguinal node dissection suggest a reduced rate of lymphedema and other postoperative complications [6, 7]. Randomized controlled trials are needed to prove the benefits of various technical modifications. The classic inguinal lymphadenectomy includes en bloc removal of all lymph node bearing fibrofatty tissue and the saphenous vein within the femoral triangle. Catalona defined the saphenous vein sparing inguinal lymphadenectomy, postulating a decrease in the postoperative
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