PubMed · 7457754
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C P Karakousis. 1981. Ilioinguinal lymph node dissection.. https://doi.org/10.1016/0002-9610(81)90181-1
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We report our experience of immediate reconstruction of the groin using the deep inferior epigastric artery (DIEA) myocutaneous flap following 32 consecutive ilioinguinal block dissections for groin metastases in patients with penile carcinoma. All groin wounds healed primarily, resulting in a short postoperative hospital stay. Transferring one or both DIEA flaps did not lead to any significant functional disability.
The wound morbidity after ilioinguinal lymph node dissections can be significantly reduced by precise planning of both the incision and the extent of flap elevation. Flap elevation extends no farther than the edges of the quadrilateral block of Anson, and exposure is best obtained with a bipedicle incision with broad-based pedicles. The broad bases ensure the greatest possibility for the sustentation of the flaps by the remaining microcirculation. All suction drains are placed far laterally, not through the base of any flaps, to avoid the high bacterial count on the skin of the groin, genitals, perineum, and anus. Closure is undertaken with a running suture, which allows for a seal that will facilitate suction. Suction continues until drainage is less than 25 mL/d.
Six cases of intranodal amianthoid myofibroblastomas are reported. Immunohistochemically the tumors were actin positive and S-100 protein and desmin negative. Intracytoplasmatic, actin-rich bodies, previously found to be a characteristic feature of this tumor, were identified as cytoplasmatic extensions filled with microfilaments at an ultrastructural level. Abortive vessel formation by the tumor cells and the proliferation of tumor cells centered on veins outside the capsule of the tumor in two of our cases indicated a close relationship between the intranodal palisaded myofibroblastoma and the musculature of vascular origin.