Complications of Surgery for Cutaneous Melanoma

There is a large variety in complications secondary to surgery for cutaneous melanoma. Problems in assessment of melanoma surgery-related morbidity and its prevention are caused by the absence or inconsistency of the definition of each complication, especially of lymphedema; the relatively limited number of studies available, which often includes a relatively small number of patients; and the frequently retrospective nature of the studies. However, most of the morbidity consists of ordinary wound complications that are generally minor, occasionally observed, and easily managed in a conventional manner. Regional chemotherapy treatment for advanced limb disease, i.e., ILP or ILI, is associated with more treatment-specific, but tolerable, morbidity. The major concern of melanoma surgery morbidity remains limb lymphedema after lymph node dissection, especially when performed in the groin. Treatment of limb lymphedema is chronic and complex. While decongestive lymphatic treatment is the initial treatment of choice, surgical treatment of lymphedema with several dedicated procedures in order to restore lymphatic drainage is emerging. In this chapter, the incidence and treatment of the various complications of surgery for cutaneous melanoma are reviewed, while measurements that potentially may reduce treatment-specific morbidity are discussed in more detail.