Introduction/Background Vulvar surgery (VC) has a major negative impact on quality of life and sexual functioning of patients. Reconstructive surgery may aid in improvement of preservation of anatomy and function of the lower genital tract and in reduction of wound complications. At present knowledge, risk factors for these wound complications, and use of reconstructive surgery for VC compared to primary closure is limited. To address this gap, a multi-center retrospective cohort study was conducted.
Methodology In four Dutch gynaecological oncological centers, we analyzed a total of 394 women who underwent surgery between January 2018 and December 2021. Incidence of wound complications was described. To evaluate the effect of reconstructive surgery we compared two groups: a group with primary closure (n=337), and a group with reconstructive surgery (n=57). Outcomes included wound complications, and tumor-free margins. A multivariate logistic regression model was performed to evaluate the risk factors for wound complications and tumor-free margins.
Results In total 56.1% of the patients suffered wound complications. Factors that increase the likelihood of wound complications include larger tumor diameter, smaller distance to the anus, and to the urethra. Multivariate logistic regression shows that there was no significant difference in wound complications between the group with primary closure versus the group with a reconstructive method (OR 1.8, CI 0.7–4.3, p=0.210). In tumor groups <2 cm and >4cm reconstructive surgery seems to result in more tumor free margins after operations.
Conclusion We observed a high incidence (56.1%) of wound complications. Tumor diameter, perineal location, and location near anus and urethra were clear risk factors identified to increase their likelihood. Furthermore, results show that the use of reconstructive surgery for larger tumors does not increase the risk of wound complications. Also, reconstructive surgery enables enhanced complete resection rates of larger vulvar tumors which could result in better anatomical restore.
Disclosures The authors declare no conflicts of interest or disclosures.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.