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Mohs 显微外科治疗皮肤肿瘤的管理。

Management of cutaneous tumors with mohs micrographic surgery.

机构信息

Department of Dermatology, Division of Dermatologic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas.

出版信息

Semin Plast Surg. 2008 Nov;22(4):247-56. doi: 10.1055/s-0028-1095884.

DOI:10.1055/s-0028-1095884
PMID:20567701
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2884874/
Abstract

Since the inception of Mohs micrographic surgery in the 1930s, this technique has proved its utility in the treatment of cutaneous tumors. This review describes the technique of Mohs micrographic surgery and the various indications for which it is used. We discuss the use of Mohs micrographic surgery for the following cutaneous tumors: basal cell carcinoma, squamous cell carcinoma, melanoma in situ, dermatofibrosarcoma protuberans, Merkel cell carcinoma, microcystic adnexal carcinoma, atypical fibroxanthoma, and sebaceous carcinoma. Mohs micrographic surgery is cost effective in the U.S. health care system because billing for the surgeon-pathologist and laboratory processing is bundled together. However, Mohs micrographic surgery may be more expensive in European systems because the Mohs technique surgeon, pathologist, and laboratory fees may be billed separately.

摘要

自 20 世纪 30 年代莫氏显微外科手术问世以来,该技术已被证明在治疗皮肤肿瘤方面具有实用性。本文介绍了莫氏显微外科手术的技术和各种适应证。我们讨论了莫氏显微外科手术在以下皮肤肿瘤中的应用:基底细胞癌、鳞状细胞癌、原位黑色素瘤、隆突性皮肤纤维肉瘤、默克尔细胞癌、微囊性附件癌、非典型纤维黄色瘤和皮脂腺癌。在美国的医疗保健体系中,莫氏显微外科手术具有成本效益,因为外科医生-病理学家和实验室处理的计费是捆绑在一起的。然而,由于莫氏技术外科医生、病理学家和实验室的费用可能分开计费,因此在欧洲体系中,莫氏显微外科手术可能更昂贵。

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本文引用的文献

1
Mohs surgery for the treatment of melanoma in situ: a review.莫氏手术治疗原位黑色素瘤:综述
Dermatol Surg. 2007 Apr;33(4):395-402. doi: 10.1111/j.1524-4725.2007.33085.x.
2
An algorithm for the reconstruction of complex facial defects.一种用于复杂面部缺损重建的算法。
Skin Therapy Lett. 2007 Mar;12(2):6-9.
3
Treatment and outcomes of malignant melanoma of the eyelid: a review of 29 cases in Australia.眼睑恶性黑色素瘤的治疗与预后:澳大利亚29例病例回顾
Ophthalmology. 2007 Jan;114(1):187-92. doi: 10.1016/j.ophtha.2006.08.043. Epub 2006 Nov 30.
4
Cost-effectiveness of Mohs Micrographic Surgery vs Surgical Excision for Basal Cell Carcinoma of the Face.莫氏显微外科手术与手术切除治疗面部基底细胞癌的成本效益分析
Arch Dermatol. 2006 Feb;142(2):187-94. doi: 10.1001/archderm.142.2.187.
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Management of scalp dermatofibrosarcoma protuberans.头皮隆突性皮肤纤维肉瘤的管理。
Dermatol Surg. 2005 Nov;31(11 Pt 1):1428-33. doi: 10.2310/6350.2005.31209.
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Surgical reconstruction of lentigo maligna defects.恶性雀斑样痣缺损的手术重建
Arch Facial Plast Surg. 2005 Sep-Oct;7(5):342-6. doi: 10.1001/archfaci.7.5.342.
7
Presurgical curettage appropriately reduces the number of Mohs stages by better delineating the subclinical extensions of tumor margins.术前刮除术通过更好地描绘肿瘤边缘的亚临床扩展,适当地减少了莫氏分期的数量。
Dermatol Surg. 2005 Sep;31(9 Pt 1):1094-9; discussion 1100. doi: 10.1097/00042728-200509000-00002.
8
Surgical margins in the treatment of nonmelanoma skin cancer and mohs micrographic surgery.非黑色素瘤皮肤癌治疗中的手术切缘与莫氏显微外科手术
Curr Surg. 2005 Sep-Oct;62(5):518-26. doi: 10.1016/j.cursur.2005.01.003.
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Ultrarapid staining for cutaneous melanoma: study and protocol.
Dermatol Surg. 2005 Jul;31(7 Pt 1):753-6; discussion 756. doi: 10.1097/00042728-200507000-00004.
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Dermatofibrosarcoma protuberans of the face: surgical management.面部隆突性皮肤纤维肉瘤:手术治疗
J Craniofac Surg. 2005 May;16(3):439-43. doi: 10.1097/01.scs.0000148045.80745.fa.