Management of the Groin in Clinically Node Positive cN Patients

Surgery remains the cornerstone of treatment in patients with metastatic disease in the groins. Cure can be attained in approximately 80% of patients who have one or two involved inguinal nodes without extranodal extension.1-7 Preoperatively, inguinal nodal involvement can be found with FNAC or excision biopsy. We prefer FNAC as it is easily performed in an out-patient setting, it is relatively noninvasive, and it does not interfere with the subsequent lymphadenectomy. Although the reported sensitivity of FNAC is higher in cN+ patients compared to cN0 patients, it is recommended to repeat the ultrasound with FNAC when clinical suspicion remains despite tumor-negative cytological results. If doubt remains an excision biopsy is advised. In removing the

Fig. 9.5 (a) Preferred incision, parallel to the inguinal ligament and a few centimeters under the inguinal crease. (b) Preferred incision for right inguinal lymphadenectomy, appearance after lymphadenectomy

Fig. 9.5 (a) Preferred incision, parallel to the inguinal ligament and a few centimeters under the inguinal crease. (b) Preferred incision for right inguinal lymphadenectomy, appearance after lymphadenectomy

suspicious enlarged node the surgeon should pay attention to the anatomical localization of the inguinal incision, as the inguinal scar should be removed at the time of completion inguinal lymphadenectomy. Patients presenting with fixed inguinal nodes are candidates for neoadjuvant chemotherapy prior to undergoing surgery.64

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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