Cernea Claudio R, Velasco Otavio, Gomes Marcos Q T, Vellutini Eduardo, Hojaij Flavio C, de Carlucci Dorival, Nishio Sunao, Morais-Besteiro Julio, Ishida Luis C, Ferraz Alberto R
Department of Head and Neck Surgery, University of São Paulo Medical School, São Paulo, Brazil.
ORL J Otorhinolaryngol Relat Spec. 2006;68(2):83-7. doi: 10.1159/000091208. Epub 2006 Jan 27.
In advanced head and neck tumors margins are very rarely comprehensively checked by frozen sections. The goal of this study was to analyze a new proposal for harvesting margins using a double-bladed scalpel.
Thirty-eight patients underwent a comprehensive resection of advanced head and neck tumors with a double-bladed scalpel. Margins were mapped and checked by frozen sections, while tumor resection continued. When positive margins were identified, they were excised again, and checked by frozen sections.
Thirty-three patients (87%) had clear skin and soft tissue margins at frozen sections. Five patients (13%) had focal skin and soft tissue-positive margins at frozen sections, which were re-excised. Two patients (5%) had skin and soft tissue-positive margins only at permanent sections. One was reoperated and 1 received radiation therapy. The 3-year local control rate was 58%.
In this preliminary study, the double-bladed scalpel appeared to be an interesting option for complete intraoperative evaluation of surgical margins of advanced head and neck tumors.
在晚期头颈肿瘤中，很少通过冰冻切片全面检查切缘。本研究的目的是分析一种使用双刃手术刀获取切缘的新方法。
38例患者接受了使用双刃手术刀对晚期头颈肿瘤进行的根治性切除术。在肿瘤切除过程中，对切缘进行标记并通过冰冻切片检查。当发现切缘阳性时，再次切除并通过冰冻切片检查。
33例患者（87%）在冰冻切片时皮肤和软组织切缘清晰。5例患者（13%）在冰冻切片时切缘局部皮肤和软组织阳性，予以再次切除。2例患者（5%）仅在永久切片时切缘皮肤和软组织阳性。1例再次手术，1例接受放射治疗。3年局部控制率为58%。
在这项初步研究中，双刃手术刀似乎是术中全面评估晚期头颈肿瘤手术切缘的一个有意义的选择。
