III期黑色素瘤患者软组织转移灶的术前超声引导下锚定线标记
Presurgical ultrasound-guided anchor-wire marking of soft tissue metastases in stage III melanoma patients.
作者信息
Voit C, Proebstle T M, Winter H, Kimmritz J, Kron M, Sterry W, Schwürzer M
机构信息
Department of Dermatology, Charité, Humboldt University of Berlin, Germany.
出版信息
Dermatol Surg. 2001 Feb;27(2):129-32. doi: 10.1046/j.1524-4725.2001.00213.x.
BACKGROUND
Due to increased sensitivity of diagnostic procedures, soft tissue metastases in melanoma patients are frequently detected very early. However, small sizes, deep location, or position close to vulnerable structures could render subsequent surgery quite difficult.
OBJECTIVE
To test the feasibility and effectiveness of presurgical ultrasound-guided anchor-wire marking of melanoma metastases.
METHODS
We selected melanoma patients with cytologically proven metastases in clinical stage III which were either unfavorably located or which have failed removal by previous surgery. Anchor-wire marking was performed ultrasound guided and free-hand style without the use of local anesthesia.
RESULTS
Twelve procedures in nine patients were well tolerated without any complications. In 11 cases the wire tip proved to be located within the tumor lesion; in one case the wire tip missed the target by less than 5 mm and thus was close enough to support appropriate surgery. Earlier, 3 of the 12 study lesions had undergone unsuccessful surgery. The median diameter of the removed metastases was 18.5 mm (range 7-30 mm).
CONCLUSION
Ultrasound-guided anchor-wire marking of unfavorably located melanoma metastases is feasible and might facilitate subsequent surgery.
背景
由于诊断程序的敏感性提高，黑色素瘤患者的软组织转移灶常常在很早的时候就被发现。然而，转移灶尺寸小、位置深或靠近易损结构可能会使后续手术相当困难。
目的
测试术前超声引导下对黑色素瘤转移灶进行锚定线标记的可行性和有效性。
方法
我们选择了临床分期为III期且经细胞学证实有转移灶的黑色素瘤患者，这些转移灶位置不佳或之前手术切除失败。在不使用局部麻醉的情况下，以徒手方式在超声引导下进行锚定线标记。
结果
9例患者的12次操作耐受性良好，无任何并发症。11例中线头位于肿瘤病灶内；1例线头偏离目标不到5毫米，因此距离足够近以支持适当的手术。此前，12个研究病灶中有3个手术未成功。切除的转移灶的中位直径为18.5毫米（范围7 - 30毫米）。
结论
超声引导下对位置不佳的黑色素瘤转移灶进行锚定线标记是可行的，并且可能有助于后续手术。
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