Bertheuil, N., Sulpice, L., Levi Sandri, G.B., Lavoue, V., Watier, E., & Meunier, B. (2015). Inguinal lymphadenectomy for stage III melanoma: a comparative study of two surgical approaches at the onset of lymphoedema. European Journal of Surgical Oncology, 41, 215–219.

DOI Link

Study Purpose

To compare the difference in occurrences of lymphedema and other postoperative complications following two different surgical approaches for stage 3 melanoma

Intervention Characteristics/Basic Study Process

Researchers divided patients into two groups, one that received vertical incisions, and another that received transverse incisions. Taking into account individual variables and any postoperative issues, patients were retrospectively studied for the presence of lymphedema.

Sample Characteristics

  • N = 53  
  • AVERAGE AGE = 52.79 years
  • MALES: 45% (rounded up), FEMALES: 55% (rounded up)
  • KEY DISEASE CHARACTERISTICS: Histologic type of melanoma; Breslow's depth; Clark's level; ulceration and regression
  • OTHER KEY SAMPLE CHARACTERISTICS: The presence of lymphedema, personal characteristics (i.e., height, weight, age, sex, body mass index, smoking status), skin necrosis, wound separation or infection, and seromas were taken into account.

Setting

  • SITE: Single site  
  • SETTING TYPE: Outpatient  
  • LOCATION: Centre Hospitalier Universitaire, Rennes, France

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active antitumor treatment
  • APPLICATIONS: Palliative care 

Study Design

Retrospective chart review

Measurement Instruments/Methods

  • Lymphedema was considered present or not present according to medical charts.
  • There was no specific description of how lymphedema was measured or graded.

Results

No statistically significant difference was noted between the two groups regarding any variable or characteristics, including the primary lymphedema status.

Conclusions

The difference in surgical approach didn't influence surgical outcomes, potential complications, or potential for chronic lymphedema.

Limitations

  • Small sample (< 100)
  • Baseline sample/group differences of import
  • Risk of bias (no control group) 
  • Risk of bias (no random assignment)
  • Risk of bias (sample characteristics)
  • Key sample group differences that could influence results
  • Measurement/methods not well described
  • Measurement validity/reliability questionable
 

 

Nursing Implications

This study did not have a direct effect on nursing practice other than to help inform nurses about the low potential for surgical approaches to have a negative effect on outcomes.