Reliability and cost-effectiveness of sentinel lymph node excision under local anaesthesia versus general anaesthesia for malignant melanoma: a retrospective analysis in 300 patients with malignant melanoma AJCC Stages I and II

Journal of the European Academy of Dermatology and Venereology : JEADV
Ingo StoffelsJoachim Klode

Abstract

Sentinel lymph node excision (SLNE) for the detection of regional nodal metastases and staging of malignant melanoma has resulted in some controversies in international discussions, as it is a cost-intensive surgical intervention with potentially significant morbidity. The present retrospective study seeks to clarify the effectiveness and reliability of SLNE performed under tumescent local anaesthesia (TLA) and whether SLNE performed under TLA can reduce costs and morbidity. Therefore, our study is a comparison of SLNE performed under TLA and general anaesthesia (GA). We retrospectively analysed data from 300 patients with primary malignant melanoma with a Breslow index of ≥1.0 mm. Altogether, 211 (70.3%) patients underwent SLNE under TLA and 89 (29.7%) patients underwent SLNE under GA. A total of 637 sentinel lymph nodes (SLN) were removed. In the TLA group 1.98 SLN/patient and in the GA group 2.46 SLN/patient were removed (median value). Seventy patients (23.3%) had a positive SLN. No major complications occurred. The costs for SLNE were significantly less for the SLNE in a procedures room performed under TLA (mean € 30.64) compared with SLNE in an operating room under GA (mean € 326.14, P<0.0001). In conclusion, SLNE perform...Continue Reading

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Citations

Jul 18, 2016·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·J A MoodyJ T Hardwicke
Jul 31, 2002·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Paul MuntnerThomas V Perneger
Feb 19, 2017·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Daniela GöppnerHarald Gollnick
Feb 19, 2017·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Daniela GöppnerHarald Gollnick
Apr 18, 2020·Biological Reviews of the Cambridge Philosophical Society·Benjamin L Allen, Jordan O Hampton
May 27, 2017·Indian Journal of Surgical Oncology·Mario Victor NewtonC Prasad
Jun 8, 2018·European Journal of Nuclear Medicine and Molecular Imaging·Benedikt Michael SchaarschmidtThorsten Dirk Pöppel
Jun 10, 2020·Annals of Surgical Oncology·Yinin HuMary S Brady
Nov 23, 2011·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Ingo StoffelsJoachim Klode
Feb 11, 2021·Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG·Julia EckardtLukas Kofler

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