Department of Dermatology and Venereology, Institute of Clinical Sciences at the Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Acta Derm Venereol. 2021 Mar 23;101(3):adv00421. doi: 10.2340/00015555-3784.
Incomplete excisions of melanocytic lesions occur despite the intention of complete removal. The aim of this study was to determine the incomplete excision rates for benign and malignant melanocytic lesions and the associated risk factors. Demographic, clinical, and histo-pathological data possibly associated with incomplete excision were collected from 2,782 consecutive excisions between 2014 and 2015. Of these, 269 melanocytic lesions (9.7%) were incompletely excised. Multivariate analysis revealed the following risk factors for significantly higher incomplete excision rates: lesions located in the head and neck area (odds ratio (OR) 3.95, 95% confidence interval (95% CI) 2.35-6.65), surgery performed by general practitioners (OR 3.01, 95% CI 2.16-4.19), the use of a punch excision technique (OR 2.83, 95% CI 1.96-4.08), and excision of non-dysplastic naevi (OR 1.58, 95% CI 1.11-2.23). In conclusion, more caution should be taken when excising melanocytic lesions in the head and neck area, general practitioners require more surgical training, and punch excisions of melanocytic lesions should be avoided.
尽管意图完全切除，但仍会出现黑素细胞病变的不完全切除。本研究旨在确定良性和恶性黑素细胞病变的不完全切除率及其相关危险因素。从 2014 年至 2015 年连续切除的 2782 例中收集了可能与不完全切除相关的人口统计学、临床和组织病理学数据。其中，269 例黑素细胞病变（9.7%）未完全切除。多变量分析显示，以下因素与不完全切除率显著升高相关：病变位于头颈部（比值比 (OR) 3.95，95%置信区间 [95%CI] 2.35-6.65）、普通科医生进行手术（OR 3.01，95%CI 2.16-4.19）、使用冲孔切除技术（OR 2.83，95%CI 1.96-4.08）以及切除非发育不良痣（OR 1.58，95%CI 1.11-2.23）。总之，在头颈部切除黑素细胞病变时应更加小心，普通科医生需要更多的手术培训，应避免使用冲孔切除黑素细胞病变。
