Sentinel lymph node biopsy under local anaesthesia versus general anaesthesia: reliability and cost-effectiveness analysis in 153 patients with malignant melanoma.

Aim: The aim of our study was to evaluate feasibility, reliability and cost-benefit balance of sentinel node (SN) biopsies conducted under local anaesthesia (LA) in patients affected by stage I-B or II cutaneous melanoma. Patients and Methods: A retrospective analysis was carried out in 153 patients, evaluating the number of harvested lymph nodes, perioperative and postoperative complications, operating time and operating room costs, comparing interventions under LA and general anaesthesia (GA). Operations were carried out under LA in 112 cases (73%) and under GA in the remaining 41(27%). Results: The mean number of removed SN was overall higher in the GA group but was not significantly different under LA with respect to the subgroups of axillary biopsies. No difference was noted in the number of complications. Operating time was significantly shorter under LA, with significantly lower costs. Conclusion: LA for groin and axillary SN biopsies can be a reliable and effective alternative to GA in melanoma patients, with shorter operating time, lower costs and without the side-effects and risks associated with GA.