Comparing the morbidity of single versus separate incision surgical approaches to vulvar cancer

Objective: To describe the morbidity of single incision approach to groin node surgery via the vulvar incision versus the separate incision approach. Methods: From 1988 to 1996, 2 surgical approaches were used in the treatment of vulvar cancer at London Health Sciences Centre. The separate incision approach uses a vulvar excision with separate groin incisions for the node dissection. The single incision approach uses the vulvar incision as a means of accessing each groin to remove the primary lesion, the inguinal femoral lymph nodes, and the intervening lymphatic tissue. We conducted a retrospective review of women with stage I, II, or III squamous vulvar cancer who were treated with surgery as their initial management. Results: There were 21 patients in the separate incision group and 31 patients in the single incision group. Univariate analysis showed no difference in patient characteristics. Overall survival and recurrence rate was not different between the groups. Operative differences included a higher rate of intraoperative blood loss and transfusion (P = .03) in the one incision group. Length of stay, wound breakdown, cellulitis, and leg edema was not different between the 2 groups. Conclusions: The single incision approach for the surgical management of vulvar cancer appears to offer no specific advantages over the current conventional approach, while wound complication rates did not appear to be reduced through the use of a single incision.