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[Bernard-Soltan technique in surgical treatment of lower lip cancer]
Włodzimierz Karcz1, Stanisław Głuszek, Jerzy Szebla
1Z Oddziału Chirurgii Ogólnej i Onkologicznej Wojewódzkiego Specjalistycznego Zespołu Opieki Zdrowotnej Gruźlicy i Chorób Płuc w Kielcach, Szpital Czerwona Góra.
Unlabelled:
In Poland lower lip cancer accounts for 0.7% all malignant tumours: 1.3% in men and 0.3% in women. In tumours involving more than 1/3 of the lip resection with simultaneous reconstruction is necessary. Recommended methods include Bernard technique modified by Soltan, Webster technique, and Karapandzic technique. The aim of the study was outcome evaluation of surgical treatment of lower lip cancer, particularly as a result of Bernard procedure modified by Soltan.
Material And Methods:
60 patients underwent surgical treatment for lower lip cancer between 1994 and 1998. In 25 patients resection with simultaneous lower lip reconstruction was made using Bernard technique modified by Soltan. Of them, 20 patients were followed-up. Sex, age, place of living, clinical TNM stage, pathology report and resection radicality, recurrence after radiotherapy, wound healing and cosmetic and functional results of surgery were analysed.
Results:
Lower lip cancer involving more than 1/3 of the lip was found in 38.8% men and 44.5% women. Among 25 patients operated using Bernard-Soltan technique, 40% were aged between 70 and 80 years. Twenty (80%) patients were country dwellers. In 60 patients' group there were 35 (58.33%) with TNM stage I, 56 (93.3%) cases of squamous spine cell carcinoma G1. In all 60 patients radicality was achieved. In 10 patients (16.7%) local recurrence after radiotherapy was treated with surgery. Wound suppuration was seen in 3 (12%) patients operated using Bernard-Soltan technique and in 1 case (4%) lobe necrosis with salivary fistula also occurred. In long-term follow-up lip sensation disorders were reported by 5 patients (mild in 3 cases--18.75% and significant in 2 cases--12.5%), speech disorders by 5 patients (mild in 4 cases--25% and significant in 1 case--6.25%). Saliva leakage was observed in 4 patients (mild in 3 cases--18.75% and significant in 1 case--6.25%). Cosmetic result was very good in 8 patients (50%), good in 6 patients (37.5%) and poor in 2 patients (12.5%).
Conclusion:
In locally advanced lower lip cancers surgical treatment using Bernard-Soltan technique results in good both early and long-term cosmetic and functional outcomes as well as a good oncological radicality.
