1. Audit of Results of Lid Tumour Excision
Shah P, Shah B, Nyunt M, Fox, P Worthing Hospital, Western Sussex Hospitals NHS Trust, England
Background
To audit our results following lid tumour excision
Is our service inferior because Mohs micrographic surgery is not practiced?
Methods
Case notes of 29 patients who underwent Eyelid tumour excision were reviewed in this retrospective audit.
From January 2010 to December 2010
Waiting times, recurrence rates, post operative complications, and cosmetic results were studied
Plan
Prior Biopsy
Waiting Times
Out of the 19 who had previous biopsy results:
7 were planned to have primary reconstruction
Changed to secondary on table in 2
11 were to have secondary reconstruction
Changed to primary reconstruction in 3
There was no plan in one
19 (65.5%) had biopsy results before surgery
2 underwent shave excision at the time of biopsy.
9 had no prior biopsy results
6 had previous history or were referred form dermatology
3 could have avoided surgery (1 scar tissue and 2 hydrocystomas)
55% were operated within 2 months.
79.3% within 3 months
One with Sebaceous Ca waited only a week.
Clearance
Type of Lesions
Post-operative Complications
20 had no mention of margin of clearance in the notes
8 had
One did not have any margin clearance (benign lesion clinically, and hydrocystoma on HP)
20 (80%) had adequate margin clearance on HP
6 (20%) did not and underwent repeat surgery
BCC - 22
Nodular - 17
Infiltrative - 3
Noduloulcerative - 2
SCC - 3
Sebaceous Carcinoma - 1
Scar Tissue - 1
Hydrocystoma - 2
11(37.9%) had postop complications
Results
Recommendations
6(20%) underwent repeat surgery due to inadequate clearance
One (3.4%) was due to inadequate deep clearance
Finally, the clearance rate was a 100% after second excision
No recurrence at 6 months’ follow up.
Prior biopsy in all unless clinically obvious
All patients to be referred to Oculoplastic service before being listed
Margin of clearance to be mentioned in notes
Photo before shave excision biopsy
Mohs / Frozen section for large tumours
Conclusion
Results comparable with literature
Histologic and Cosmetic results satisfactory