Radical mastectomy for vulvar cancer

This procedure, also known as the Way of the Way, is performed in the same time for extensive vulvar resection and bilateral groin, and if necessary, a pelvic lymph node is continuously removed. In the 1940s, Way proposed a surgical method for yin cancer. Although it has evolved over the years, it has formed a variety of surgical procedures as described above, but the Way is still the classic standard for the treatment of advanced vulvar cancer. Another type of surgery, called radical surgery (basssradicalvulvectomy), also known as Basset surgery refers to the simultaneous or staged extensive vulvectomy and groin, pelvic lymphadenectomy. The indications are the same as the Way of the Way, the difference between the two is the difference in the incision. The Basset procedure has three independent incisions (Fig. 7), and the Way's lower inferior vulvar incision is connected to the vulva incision. This procedure and Way have their own advantages and disadvantages, and should be selected according to the specific situation in clinic. Their respective advantages and disadvantages are: 1. Way can cut the vulva, groin and pelvic lymph nodes in a single block, consistent with the principle of enveloping continuous monolithic resection of malignant tumors. At the same time, it can ensure the good protection of the inguinal field. However, due to the large wound surface, it is often difficult to heal the wound after the first stage of healing. 2.Basset surgery can be based on the patient's condition extensive resection of the vulva and inguinal pelvic lymphadenectomy using simultaneous or staging surgery. The advantage of this procedure is that it is a poor constitution, a large vulvar cancer, and a wide range of feasible staging surgery. That is to say, extensive vulva resection is performed. After the wound of the vulva is healed, the inguinal and pelvic lymphadenectomy is performed to make the wounds smaller after surgery, which is beneficial to wound healing. However, if the procedure is the same as the same operation, the wound in the groin is difficult to heal, and the complications of postoperative lower limb lymphatic drainage disorder are higher. Treatment of diseases: vulvar cancer Indication 1. Vulvar invasive cancer is located in the midline. 2. Vulvar cancer inguinal hernia and suspicious metastatic lymph nodes. Surgical procedure 1. Incision: a combined incision for the abdominal vulva. From the anterior superior iliac spine, the pubic symphysis upper edge, the arc-shaped incision of the anterior superior iliac spine, and the vulvar fusiform outer incision at the midpoint. 2. Excision of abdominal lymphoid adipose tissue: cut the abdominal skin along the incision line, lift the upper part of the incision, and release the upper abdominal flap about 6-8 cm. The root of the flap should be sloped. From the root of the flap, the fascial anterior fat of the abdominal wall was removed from the top to the bottom, to the pubic symphysis and the inguinal ligaments on both sides. 3. Excision of lymphatic adipose tissue in the groin and the thigh triangle: the bilateral femoral flaps were separated, and the lymphatic adipose tissue of the groin and the trigone was excised from the outside to the inside, and the saphenous vein was preserved or ligated. The ligament was found in 1/3 of the inguinal ligament and below the pubic tuberosity, and was cut and sutured. The femoral canal was dissected, and the Cloquet lymph nodes were removed separately and sent to the pathology for rapid freezing examination. The left and right inguinal lymphoid adipose tissue were connected to both sides of the sputum. 4. Excision of pelvic lymphatic adipose tissue: if pelvic lymph node dissection is required. 5. Extensive resection of the vulva: extensive vulvectomy. 6. Stitching and placement of drainage: The method is as described above.

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