Nadra Sultana, Sobia Naz.
Radical vulvectomy by two different surgical incisions.
J Pak Med Assoc Jan ;57(2):74-7.

Objective: To determine the outcome of radical vulvectomy by two different surgical incisions (butterfly vs triple incision) for the treatment of vulval carcinoma. Methods: A comparative study was conducted from January 1992 to July 2003 at Military Hospital Rawalpindi and Fauji Foundation Hospital Rawalpindi. A total of 35 patients were included in this study. One patient received supportive therapy at stage IVB. Out of 34 patients, 23 (67.64%) underwent radical vulvectomy by butterfly incision and 11 (32.35%) radical vulvectomy by triple incision technique. Data regarding history, clinical examination, surgical procedures, per-operative complications, post-operative complications, hospital stay, recurrence and mortality was collected and analyzed. Results: The percentages of partial wound dehiscence (86.36% vs 18.18% p=0.00), wound induration (100% Vs 72.7%, p=0.008), infection (22.72% Vs: 9.09%, p=0.637) and lymphoedema (9.0% vs Zero, p=0.542) were higher in butterfly incision group as compared to triple incision group respectively. The per-operative blood loss (750 ± 36.9ml vs 381 ± 14.7ml, p-value: < 0.01), operative time (136.91 ± 14.73 min Vs 81.82 ± 14.71 min, p= 0.00) and hospital stay (19.05 ± 3.27 days Vs 9.09 ± 0.7 days, p=0.00) were significantly higher in butterfly incision as compared to triple incision respectively. The recurrence rate in butterfly incision was comparable to triple incision group (14.28% vs 18.18%, p=0.572). In the butterfly group one patient died per-operatively and another patient died within one year after surgery. Conclusion: Radical vulvectomy by triple incision has comparable recurrence rate but significantly less mortality and morbidity rates when compared to butterfly incision (JPMA 57:74;2007).

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