Mason Lauren B, Reddy Deepthi M, Crosson Jason N, Mason John O
Retina Consultants of Alabama P.C., Birmingham, Alabama.
Retina Consultants of Alabama P.C., Birmingham, Alabama; Department of Ophthalmology, University of Alabama-Birmingham, Birmingham, Alabama.
Ophthalmol Retina. 2017 Nov-Dec;1(6):555-558. doi: 10.1016/j.oret.2017.03.009. Epub 2017 May 19.
To evaluate the outcomes of choroidal melanoma 25-gauge vitrectomy needle biopsy and iodine 125 (I) brachytherapy performed by supervised fellows compared with experienced faculty.
Retrospective, observational case series.
Sixty-three consecutive eyes of 63 patients with treatment-naïve medium choroidal melanomas without extraocular extension.
Sixty-three consecutive eyes of 63 patients undergoing simultaneous I brachytherapy and 25-gauge vitrectomy melanoma biopsy for choroidal melanoma. One attending surgeon performed 31 surgeries and 2 fellows performed 32 surgeries. All cases treated by fellows were under direct supervision of the attending physician.
Percentage of adequate biopsy sample, tumor regression, and postoperative complications.
There were no baseline differences between the groups. The biopsy yield for gene expression profile and the melanoma regression rate were equal in both groups (63/63 [100%]; P = 1.0). Complications occurred in 1 of 31 faculty surgery patients (transient vitreous hemorrhage) and in 0 of 32 fellow surgery patients (P = 1.0).
With proper supervision, fellows can achieve equally high biopsy yield and melanoma regression rate with few complications compared with experienced faculty.
评估在有经验的教员指导下，由进修医生进行的脉络膜黑色素瘤25G玻璃体切割针吸活检及碘125（I）近距离放疗的效果，并与有经验的教员进行比较。
回顾性观察病例系列。
63例初治的中等大小脉络膜黑色素瘤且无眼外侵犯患者的63只连续眼。
63例患者的63只连续眼同时接受I近距离放疗及25G玻璃体切割黑色素瘤活检以治疗脉络膜黑色素瘤。1名主治医生进行了31例手术，2名进修医生进行了32例手术。进修医生治疗的所有病例均在主治医生的直接监督下进行。
足够活检样本的百分比、肿瘤退缩情况及术后并发症。
两组之间无基线差异。两组的基因表达谱活检成功率及黑色素瘤退缩率相同（63/63 [100%]；P = 1.0）。主治医生手术的31例患者中有1例发生并发症（短暂性玻璃体出血），进修医生手术的32例患者中无并发症发生（P = 1.0）。
在适当的监督下，与有经验的教员相比，进修医生能够获得同样高的活检成功率和黑色素瘤退缩率，且并发症较少。
