Kim Keun Tae, Sun Hook, Chung Eui Han
Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.
Arch Craniofac Surg. 2019 Apr;20(2):84-88. doi: 10.7181/acfs.2018.02152. Epub 2019 Apr 20.
Epidermal cysts are benign, slow growing cysts that often develop on the head, neck, chest, and back of adults. The most common method of surgical excision involves the use of a scalpel and often leaves a scar proportional to the size of the cyst. Therefore, minimally invasive techniques are required. Among these techniques, the CO2 laser-based technique is minimally invasive and has lower complication rate, shorter recovery times, and lesser scarring. This paper aimed to compare the results and postoperative complications associated with a CO2 laser-based excision against conventional surgical excision for epidermal cysts.
We surveyed 120 patients, aged 16 to 65 years, with epidermal cysts on the face measuring 0.5 to 2.2 cm in diameter. Twelve months later, we compared the scar length, recurrence rate, patient satisfaction, and complications between patients treated with CO2 laser excision versus surgical excision.
The mean scar length (12 months postoperative) after CO2 laser excision was 0.30± 0.15 cm, and that following surgical excision was 1.23± 0.43 cm (p= 0.001). The procedure time (time from incision after local anesthesia to the end of repair) was 16.15± 5.96 minutes for CO2 laser excision versus 22.38± 6.05 minutes for surgical excision (p= 0.001). The recurrence rates in the surgical excision group and CO2 laser excision group were 3.3% and 8.3%, respectively; this difference was not statistically significant (p= 0.648).
The cosmetic outcome of CO2 laser excision is excellent. For epidermal cysts measuring 2.2 cm or smaller, CO2 laser excision is recommended, especially when aesthetic outcome is considered important.
表皮样囊肿是良性、生长缓慢的囊肿，常见于成年人的头、颈、胸和背部。最常见的手术切除方法是使用手术刀，术后常留下与囊肿大小成正比的疤痕。因此，需要微创技术。在这些技术中，基于二氧化碳激光的技术具有微创性，并发症发生率较低，恢复时间较短，疤痕较小。本文旨在比较基于二氧化碳激光切除与传统手术切除表皮样囊肿的效果及术后并发症。
我们调查了120例年龄在16至65岁之间、面部有直径0.5至2.2厘米表皮样囊肿的患者。12个月后，我们比较了接受二氧化碳激光切除与手术切除的患者之间的疤痕长度、复发率、患者满意度和并发症情况。
二氧化碳激光切除术后（术后12个月）的平均疤痕长度为0.30±0.15厘米，手术切除后的平均疤痕长度为1.23±0.43厘米（p = 0.001）。二氧化碳激光切除的手术时间（从局部麻醉后切开至修复结束的时间）为16.15±5.96分钟，手术切除为22.38±6.05分钟（p = 0.001）。手术切除组和二氧化碳激光切除组的复发率分别为3.3%和8.3%；差异无统计学意义（p = 0.648）。
二氧化碳激光切除的美容效果极佳。对于直径2.2厘米或更小的表皮样囊肿，建议采用二氧化碳激光切除，尤其是当美学效果被认为很重要时。
