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术中冰冻切片在非黑色素瘤皮肤癌患者手术治疗中的应用

Use of Intraoperative Frozen Section in the Surgical Management of Patients with Nonmelanoma Skin Cancer.

作者信息

Loh LiAnn, Tiwari Priya, Lee Jingtzer, Low O-Wern, Nallathamby Vigneswaran, Lee Hanjing, Lim Jane, Lim Thiam Chye, Yap Yan Lin

机构信息

NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, National University Hospital, Singapore.

出版信息

J Skin Cancer. 2021 Nov 1;2021:4944570. doi: 10.1155/2021/4944570. eCollection 2021.

Abstract

BACKGROUND

Intraoperative frozen section (IFS) is often utilised in the surgical treatment of nonmelanocytic skin cancer (NMSC) in sensitive facial regions when Mohs micrographic surgery (MMS) is not available.

OBJECTIVE

To compare the outcome of NMSC patients with excision performed with and without IFS.

MATERIALS AND METHODS

A retrospective, single-centre study was performed on all patients who had undergone resection of NMSC with and without IFS control at the National University Hospital (NUH) from 2010 to 2015.

RESULTS

116 patients were recruited, of which 86 had IFS and 30 did not. The complete excision rate of patients with IFS was higher at 87.2% (=0.0194), need for secondary operation was lower at 1.2% (=0.005), and need for postsurgery radiotherapy or chemotherapy was lower at 1.2% (=0.001). The average duration of surgery in patients who underwent IFS was 95.4 minutes compared to 70.1 minutes in cases which did not undergo IFS.

CONCLUSION

Our study showed an increased complete excision rate and reduced need for secondary surgeries and adjuvant therapy in patients with IFS. However, a longer operative duration was required. Use of IFS may be useful in patients with NMSC lesions in sensitive regions requiring complex reconstruction after tumour excision.

摘要

背景

当无法进行莫氏显微外科手术(MMS)时,术中冰冻切片(IFS)常用于面部敏感区域非黑素细胞性皮肤癌(NMSC)的手术治疗。

目的

比较有和没有IFS辅助切除的NMSC患者的治疗结果。

材料与方法

对2010年至2015年在国立大学医院(NUH)接受有和没有IFS控制的NMSC切除手术的所有患者进行了一项回顾性单中心研究。

结果

共招募了116例患者,其中86例接受了IFS,30例未接受。接受IFS的患者完全切除率更高,为87.2%(P = 0.0194),二次手术需求更低,为1.2%(P = 0.005),术后放疗或化疗需求更低,为1.2%(P = 0.001)。接受IFS的患者平均手术时间为95.4分钟,而未接受IFS的患者为70.1分钟。

结论

我们的研究表明,接受IFS的患者完全切除率提高,二次手术和辅助治疗需求减少。然而,手术时间更长。对于肿瘤切除后需要复杂重建的敏感区域NMSC病变患者,使用IFS可能有用。

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