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[显微外科手术在基底细胞癌治疗中的作用:摩洛哥非斯哈桑二世大学医院皮肤科的经验]

[The role of the micrographic surgery in the management of basal cell carcinoma: experience in the Department of Dermatology, at the Hassan II University Hospital, Fes, Morocco].

作者信息

Gallouj Salim, Aqil Niema, Harmouch Taoufiq, Mernissi Fatima Zahra

机构信息

Service de Dermatologie, CHU Hassan II de Fès, Maroc.

Service de Pathologie, CHU Hassan II de Fès, Maroc.

出版信息

Pan Afr Med J. 2019 Jul 23;33:245. doi: 10.11604/pamj.2019.33.245.18562. eCollection 2019.

Abstract

Mohs micrographic surgery (MMS) is a technique allowing for intraoperative histologic assessment of surgical margin of malignant tumors. This study aims to highlight the role of MMS in the achievement of radical healing of basal cell carcinoma (BCC) in our patients. We conducted a study of 29 patients with basal cell carcinoma of the face over a period of 5 years. The median age of patients was 45.8 years (12-80). The sex-ratio M/F was 1.23. One-stage surgical procedure was sufficient to obtain complete resection in 51% of cases. Three-stage surgical procedure was needed in 14% of the cases. The mean duration of one-stage surgical procedure was 1 hour. No complications were reported in the postoperative period and sequelae were simple. The aesthetic and functional result was satisfactory. No recurrence was noted. BCC accounts for approximately 80% of all skin cancers. The decision to use MMS to treat BCC is based on three variables: the seat and the size of the tumor, its histological appearance with the identification of resection margin and its recurrent nature. MMS is currently the most effective method in the treatment of BCC and allows maximum healthy tissue preservation. It is a safe and repeatable surgical procedure based on team work and adapted to the treatment of patients with BCC who are at high risk of recidivism. The aesthetic and functional results are satisfactory. Recurrence rate at 5 years is 10 times lower than with the other methods.

摘要

莫氏显微外科手术(MMS)是一种能够在术中对恶性肿瘤手术切缘进行组织学评估的技术。本研究旨在突出MMS在实现我们患者基底细胞癌(BCC)根治性治愈方面的作用。我们对29例面部基底细胞癌患者进行了为期5年的研究。患者的中位年龄为45.8岁(12 - 80岁)。男女比例为1.23。51%的病例一期手术即可实现完全切除。14%的病例需要三期手术。一期手术的平均时长为1小时。术后未报告并发症,后遗症轻微。美学和功能结果令人满意。未观察到复发情况。基底细胞癌约占所有皮肤癌的80%。决定使用MMS治疗基底细胞癌基于三个变量:肿瘤的位置和大小、其组织学外观以及切缘的确定情况和复发性质。MMS是目前治疗基底细胞癌最有效的方法,能够最大程度地保留健康组织。它是一种基于团队协作的安全且可重复的手术方法,适用于治疗复发风险高的基底细胞癌患者。美学和功能结果令人满意。5年复发率比其他方法低10倍。

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