[Radical vulvectomy and inguinal lymphadenectomy using a single incision for the treatment of vulvar malignancy].

Objective: To describe a novel procedure of radical vulvectomy and inguinal lymphadenectomy using a single incision (RVIL-SI) for the treatment of vulvar malignancy. Methods: In March, 2019, two cases affected with vulvar cancer (the first one is stage ⅢA squamous cell carcinoma and the second one is stage ⅠB with malignant melanoma) underwent this novel procedure, which was characterized by the combination of radical vulvectomy and bilateral inguinal lymphadenectomy without making additional incisions in groin areas. The boundaries of femoral triangle could be exposed perfectly using the initial incision of radical vulvectomy and the combined superficial and deep groin lymph node dissection were done subcutaneously from medial to lateral. Preoperative data and short term follow-up outcomes were collected. Results: The RVIL-SI was successfully conducted in two patients without any incisions of groin. The great saphenous veins were all spared. The operative time, average blood loss and median total regional lymph nodes of two cases were close. No major intraoperative complications occurred. Micrometastasis in one right superficial inguinal node was found in the first case with ipsilateral huge cancer lesion. No drain tube was left in inguinal areas intraoperatively. On postoperative day 3, the second case suffered mild lymphocele of right groin, which was resolved via repeated percutaneous needle puncture followed by elastic compression. Postoperative hospital stay of two cases were 10 and 11 days, respectively. With no skin complication at the time of writing this report. Conclusion: Our preliminary experience with the RVIL-SI has confirmed the reproducibility and minimal invasive therapeutic potential in the treatment for patients with vulvar cancer. But this novel procedure is in its infancy stage. Although short-term results are encouraging, a larger series with longer follow-up are required to fully evaluate the therapeutic efficacy.

Electron Mass Enhancement near a Nematic Quantum Critical Point in NaFe_{1-x}Co_{x}As.

A magnetic order can be completely suppressed at zero temperature (T), by doping carriers or applying pressure, at a quantum critical point, around which physical properties change drastically. However, the situation is unclear for an electronic nematic order that breaks rotation symmetry. Here, we report nuclear magnetic resonance studies on NaFe_{1-x}Co_{x}As where magnetic and nematic transitions are well separated. The nuclear magnetic resonance spectrum is sensitive to inhomogeneous magnetic fields in the vortex state, which is related to London penetration depth λ_{L} that measures the electron mass m^{*}. We discovered two peaks in the doping dependence of λ_{L}^{2}(T∼0), one at x_{M}=0.027 where the spin-lattice relaxation rate shows quantum critical behavior, and another at x_{c}=0.032 around which the nematic transition temperature extrapolates to zero and the electrical resistivity shows a T-linear variation. Our results indicate that a nematic quantum critical point lies beneath the superconducting dome at x_{c} where m^{*} is enhanced. The impact of the nematic fluctuations on superconductivity is discussed.