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[皮肤黑素细胞痣的剃除切除术:适应证、技术、结果]

[Shave excision of melanocytic nevi of the skin: indications, technique, results].

作者信息

Breuninger H, Garbe C, Rassner G

机构信息

Hautklinik der Universität Tübingen.

出版信息

Hautarzt. 2000 Aug;51(8):575-80. doi: 10.1007/s001050051174.

Abstract

BACKGROUND AND OBJECTIVE

Shave excision of nevi is a technique still under debate. Speed, simplicity, and the fact that it provides excised material for histologic examination are contrasted with the lack of excision margins and a higher rate of nevus recurrences. In this study, the pros and cons of shave excision were evaluated.

PATIENTS AND METHODS

Conventional excisions (268 nevi with intracutaneous butterfly sutures) and shave excisions (403 nevi) were compared with the patients' subjective assessments and objective parameters as recurrence, color, depth, surface smoothness of the scars, and the healing process. The nevi, found on the entire integument, ranged in diameter from 2 to 15 mm, with an average of 5 mm. A second excision was performed only in cases in which an early malignant melanoma could not be excluded.

RESULTS

Shave excisions were evaluated subjectively as being better. Shave excisions resulted in fewer complications (7.9% versus 15%), but recurrences were more frequent (18.1% versus 6.0%). There was no close relationship between histopathologic finding of complete excision and recurrences.

CONCLUSIONS

Small nevi without clinical suspicion of malignant melanoma can be removed with the shave excision technique with good results. Patients should be informed about the higher rate of recurrences. The appliance of the shave technique requires exact knowledge and experience, enabling good histopathologic examinations.

摘要

背景与目的

刮除术切除痣仍是一种存在争议的技术。其速度快、操作简单,且能提供切除组织用于组织学检查,但也存在切缘不完整以及痣复发率较高的问题。在本研究中,对刮除术的利弊进行了评估。

患者与方法

将传统切除术(268例痣采用皮内蝶形缝合)与刮除术(403例痣)进行比较,比较指标包括患者的主观评估以及复发、颜色、深度、瘢痕表面光滑度和愈合过程等客观参数。这些痣分布于全身皮肤,直径2至15毫米,平均为5毫米。仅在不能排除早期恶性黑色素瘤的情况下进行二次切除。

结果

患者主观评价刮除术效果更好。刮除术并发症较少(7.9%对15%),但复发更频繁(18.1%对6.0%)。组织病理学完全切除结果与复发之间无密切关系。

结论

对于临床上未怀疑为恶性黑色素瘤的小痣,可采用刮除术切除,效果良好。应告知患者复发率较高。刮除术的应用需要准确的知识和经验,以确保良好的组织病理学检查。

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