Patients who received simultaneous resection of primary tumor and inguinal lymph nodes were assigned to the immediate group, while other patients were assigned to the delayed group. No palpable or visibly enlarged inguinal lymph nodes when they received prophylactic surgical treatment. The cases were treated in accordance with modern treatment protocol, including standard preoperative imaging, primary tumor treatment, and standard surgical templates. Nodal staging was accomplished by physical examination and imaging. Inguinal computed tomography (CT) examination was used in obese patients in whom palpation was unreliable to exclude lymph nodes enlargement. To other patients, a physical examination of both groins was performed in order to record the number, laterality, and characteristics of inguinal nodes. If nodes were not palpable, inguinal B-ultrasound was performed first.
All these following boundaries constituted the extent of modified ILND: the spermatic cord formed the upper boundary, and the fossa ovalis formed the lower boundary; the inner and outer boundaries were the lateralis of the long adductor muscle and the femoral artery, respectively. Compared with radical ILND, the modified procedure decreased the length of the skin incision and the scope of dissection, preserved the saphenous vein and fascia lata, and avoided the transposition of the sartorius muscle, decreasing morbidity related to groin dissection (14 (link)–16 (link)).
Before 2015 all procedures were open ILNDs, and since 2015 we have performed video-endoscopic ILND. Additional ipsilateral pelvic LND (pLND) (external iliac and obturator) was performed if two or more inguinal lymph nodes were involved after ILND and adjuvant chemotherapy was provided. The Clavien-Dindo classification system was used to judge operation-related complications.
All these following boundaries constituted the extent of modified ILND: the spermatic cord formed the upper boundary, and the fossa ovalis formed the lower boundary; the inner and outer boundaries were the lateralis of the long adductor muscle and the femoral artery, respectively. Compared with radical ILND, the modified procedure decreased the length of the skin incision and the scope of dissection, preserved the saphenous vein and fascia lata, and avoided the transposition of the sartorius muscle, decreasing morbidity related to groin dissection (14 (link)–16 (link)).
Before 2015 all procedures were open ILNDs, and since 2015 we have performed video-endoscopic ILND. Additional ipsilateral pelvic LND (pLND) (external iliac and obturator) was performed if two or more inguinal lymph nodes were involved after ILND and adjuvant chemotherapy was provided. The Clavien-Dindo classification system was used to judge operation-related complications.
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