Conventional Versus Videoscopic Inguinal Lymphadenectomy in Surgical Oncology: A Retrospective Observational Cohort Study

Introduction: Inguinal lymphadenectomy is an important procedure in the treatment of various stage III malignancies and is notorious for postoperative complications, such as surgical site infections, seroma formation, skin flap necrosis, and wound breakdown. This study aims to investigate complication rates after conventional inguinal lymphadenectomy (CIL) and videoscopic inguinal lymphadenectomy (VIL) and to identify potential solutions to decrease complication rates. Methods: This was a single-center retrospective cohort study comparing CIL with VIL. Primary outcomes were the incidence of surgical complications, severity of surgical complications, readmissions, and surgical reinterventions. Additionally, drain use, flap fixation, antibiotics, unplanned visits, and oncological outcome were compared. Results: Between 2010 and 2024, 30 patients underwent CIL and 25 patients underwent VIL. The median operating time for CIL was 100 minutes (interquartile range [IQR] 88–119) compared with 120 minutes (IQR 105–139) for VIL (p = 0.017). The median duration of follow-up for patients in this cohort was 2.2 years (IQR 0.7–5.1). A total of 25 patients (83%) in the CIL group had at least one wound complication, compared with 13 (54%) in the VIL group (p = 0.020). Reinterventions in the first 30 postoperative days were performed in 12 patients (40%) after CIL, compared with none (0%) after VIL (p < 0.001). Disease-specific survival was not significantly different between procedures (p = 0.940). Conclusions: VIL reduced the rate of wound complications, severity of complications, and early surgical reinterventions compared with CIL but prolonged surgery time. The videoscopic procedure seems superior and offers a transformative approach that can be incorporated into contemporary surgical practice.