Radical vulvar cancer

This operation is also known as Way operation, which involves extensive vulvectomy and bilateral groin, and continuous monolithectomy of pelvic diaphragmatic lymph nodes if necessary. In the 1940s, Way proposed a surgical method for vulvar cancer. Although it has evolved into a variety of surgical procedures as described above over the years, the Way surgical procedure is still the classic standard surgical procedure for the treatment of advanced vulvar cancer. Another type of surgery is called radical vulvectomy (basset's radical vulvectomy). This procedure is also known as the basic vulvectomy and inguinal and pelvic lymph node dissection. Its indications are the same as Way's operation. The difference between the two lies in the incision. The Basset procedure has three independent incisions (Figure 7), and the Way's lower abdominal pubic incision is connected to the vulvar incision. This method and Way method have their own advantages and disadvantages, and should be selected and applied clinically according to the specific situation. Their respective advantages and disadvantages are as follows: 1. Way operation can be used to remove the vulva, groin and pelvic lymph nodes in one continuous block, which conforms to the principle of continuous continuous block resection of malignant tumors. At the same time, good protection of the groin surgical field can be guaranteed. However, due to the large wound, poor physical fitness and larger lesions, it is often difficult to heal the primary wound after surgery. 2.Basset operation can be performed in accordance with the patient's condition for extensive vulvectomy and inguinal pelvic lymphadenectomy using simultaneous or staged surgery. The advantages of this method are that it is feasible to perform staged surgery on those with poor constitution, large vulvar cancerous foci. That is, extensive vulvectomy is performed first, and inguinal and pelvic diaphragm lymph node dissection is performed after the vulvar wound is healed, so that the wound surface is smaller after surgery, which is conducive to wound healing. However, this method, such as concurrent surgery, makes it difficult to heal the inguinal wound, and the complications of lower extremity lymphatic reflux disorder are higher.