Gonçalves Jose Carlos Almeida
Department of Dermatology, District Hospital, Santarém, Portugal.
Dermatol Surg. 2009 Nov;35(11):1788-96. doi: 10.1111/j.1524-4725.2009.01292.x. Epub 2009 Sep 1.
Cryosurgical treatment of facial skin cancers 10 mm or larger in diameter can originate retractile scars that may alter physiognomic features.
To treat skin cancers 10 mm or larger in diameter on the face with a cryosurgical method that prevents retractile scars. Also, to clarify the differences between this method and Zacarian's segmental cryosurgery.
Fractional cryosurgery is performed in stages. First, the center of the lesion is frozen, reducing its size, then this procedure is repeated as necessary until the tumor diameter is smaller than 10 mm, at which point the standard cryosurgical procedure is performed. Eighty-seven basal cell carcinomas (BCCs) and nine squamous cell carcinomas (SCCs) of the face (65 of which were orbital or periocular) measuring between 9 and 45 mm were treated.
The cure rate of BCCs was related to tumor size. All SCCs were cured without recurrence. Global mean follow-up was 4.5 years.
Fractional cryosurgery does not cause deformity, and the final scar has no relation to the mass of the original tumor but instead corresponds to the size of the lesion preceding the last cryosurgical procedure.
对直径10毫米或更大的面部皮肤癌进行冷冻手术治疗可能会产生收缩性瘢痕,从而改变面部特征。
采用一种能防止收缩性瘢痕形成的冷冻手术方法治疗面部直径10毫米或更大的皮肤癌。此外,阐明该方法与扎卡里安分段冷冻手术之间的差异。
分步进行分次冷冻手术。首先,冷冻病变中心,缩小其大小,然后根据需要重复此操作,直到肿瘤直径小于10毫米,此时进行标准冷冻手术。对87例面部基底细胞癌(BCC)和9例鳞状细胞癌(SCC)(其中65例为眼眶或眼周病变)进行了治疗,病变大小在9至45毫米之间。
BCC的治愈率与肿瘤大小有关。所有SCC均治愈且无复发。总体平均随访时间为4.5年。
分次冷冻手术不会导致畸形,最终瘢痕与原发肿瘤大小无关,而是与最后一次冷冻手术前病变的大小相对应。