Objective: Vulvar cancer surgery is associated with high postoperative wound complication rates. Reconstructive surgery (RS) in vulvar cancer is generally reserved for surgery of extensive tumors or local recurrences. The primary aim of the study is to determine the incidence and risk factors for wound complications after vulvar cancer surgery. As a secondary aim, we compare the effects of primary closure (PC) versus reconstructive surgery on wound complications.Methods: In a retrospective cohort study in four gynecologic oncology centers in the Netherlands, patients undergoing surgical treatment (2018–2022) for vulvar cancer were included. Wound complications after PC and RS and risk factors associated with complications were analyzed by using logistic regression adjusting for confounds.Results: We included 394 women, 318 with PC and 76 with RS. The incidence of wound complications was 46.7%, with 42.4% of wound breakdowns comprising the majority of complications. The use of RS was associated with an increased risk of wound complications. Larger tumor size, proximity to the urethra, resection of the urethra during surgery, and perineal tumor location were additional risk factors for wound complications. However, after multivariate analyses, RS remained the only significant risk factor (OR 1.2; 95% CI 1.1–1.2).Conclusions: Risk factors for wound complications after vulvar cancer surgery include larger tumor size, proximity to the urethra, resection of the urethra during surgery, and perineal tumor location. RS is also associated with an increased risk of wound complications, probably related to case selection.
目的：外阴癌手术术后伤口并发症发生率较高。外阴癌重建手术通常仅用于广泛性肿瘤或局部复发的手术治疗。本研究的主要目的是确定外阴癌手术后伤口并发症的发生率及风险因素。次要目标是比较一期缝合与重建手术对伤口并发症的影响。 方法：在荷兰四家妇科肿瘤中心开展了一项回顾性队列研究，纳入2018年至2022年间接受手术治疗的外阴癌患者。通过逻辑回归分析调整混杂因素，对一期缝合与重建手术后的伤口并发症及相关风险因素进行分析。 结果：共纳入394例女性患者，其中318例接受一期缝合，76例接受重建手术。伤口并发症发生率为46.7%，其中42.4%为伤口裂开，构成主要并发症类型。重建手术与伤口并发症风险增加相关。肿瘤体积较大、邻近尿道、术中尿道切除以及会阴部肿瘤位置是伤口并发症的额外风险因素。然而，在多变量分析后，重建手术仍是唯一显著的风险因素（比值比1.2；95%置信区间1.1-1.2）。 结论：外阴癌手术后伤口并发症的风险因素包括肿瘤体积较大、邻近尿道、术中尿道切除以及会阴部肿瘤位置。重建手术也与伤口并发症风险增加相关，这可能与病例选择有关。
肿瘤(癌症)患者之家