Li Janet Y, Silapunt Sirunya, Migden Michael R, McGinness Jamie L, Nguyen Tri H
Department of Dermatology, University of Texas McGovern Medical School, Houston, Texas.
MD Anderson Cancer Center, Houston, Texas.
Dermatol Surg. 2018 Jan;44(1):1-9. doi: 10.1097/DSS.0000000000001215.
Mohs micrographic surgery (MMS) is a highly effective process that requires consistent accuracy in resection, mapping, and histologic interpretation. Although the general sequence in MMS is similar, there are numerous variations among Mohs surgeons as to how this process is performed.
This article aims to review the process of MMS, with the intent to identify and mitigate the potential errors at each step. Existing variations will be discussed and protocols offered to minimize error and optimize accuracy.
A Pubmed search was performed for publications on methods of tissue mapping, orienting, and processing in MMS.
Our literature review highlights various techniques for tissue orientation, transfer, flattening, inking, mapping, and processing of later stages and multiple specimens. We discuss our system, which reduces error during tissue transfer, tissue identification in vivo and ex vivo, and tissue flattening. Furthermore, we discuss adaptations to increase the accuracy during reexcisions of subsequent Mohs layers.
Variations in MMS reflects the diverse training and creativity among Mohs surgeons. Unless potential errors are addressed, however, false negatives will occur and undermine the superior cure rate of MMS.
莫氏显微外科手术（MMS）是一个高效的过程，在切除、绘图和组织学解读方面需要始终保持准确。虽然MMS的一般流程相似，但不同的莫氏外科医生在如何进行这个过程上存在许多差异。
本文旨在回顾MMS的过程，以识别并减少每个步骤中的潜在错误。将讨论现有的差异，并提供方案以尽量减少错误并优化准确性。
在PubMed上搜索关于MMS中组织绘图、定位和处理方法的出版物。
我们的文献综述强调了组织定位、转移、 flattening、染色、绘图以及后期和多个标本处理的各种技术。我们讨论了我们的系统，该系统可减少组织转移、体内和体外组织识别以及组织flattening过程中的误差。此外，我们还讨论了在后续莫氏层再次切除时提高准确性的调整方法。
MMS中的差异反映了莫氏外科医生之间不同的培训和创造力。然而，除非解决潜在错误，否则会出现假阴性结果，并损害MMS卓越的治愈率。
原文中“flattening”未明确含义，保留英文未翻译。
