The terms "chemosurgery," "microscopically controlled surgery," and the shortened form "microcontrolled surgery" all serve to designate a method by which cancer of the skin may be excised under complete microscopic control. This microscopic control is accomplished by excising the cancerous area layer by layer and examining the entire undersurface of each layer under the microscope by the systematic use of frozen sections. The layers of tissue may be excised after prior chemical fixation of the tissues with zinc chloride (the fixed tissue technique) or the layers may be excised in the fresh, unfixed state after injection of a local anesthetic (the fresh tissue technique). The fixed tissue technique is indicated for extensive, complicated cancers that invade into or around bony structures, for cancers invading the erectile tissues of the penis, and for melanoma. The fresh tissue technique is indicated for almost all other cutaneous cancers. Dual advantages conferred by the microscopic control are, first, guarantee of eradication of the cancer, including its clinically unpredictable ramifications and, second, the maximal conservation of normal tissues. The operative risk is low because no general anesthetic is used and because patients remain ambulatory. The tissues heal well whether by second intention or by immediate or delayed repair. The microscopic control, as well as the other technical advantages of the method, extends operability to some patients with cancers so extensive and complicated that there would be little likelihood of cure with methods lacking such control. Facilities and trained personnel for the use of microcontrolled surgery eventually should be available in all large population centers.
“化学外科手术”“显微镜控制下的手术”以及缩写形式“微控手术”这些术语都用于指代一种可在完全显微镜控制下切除皮肤癌的方法。这种显微镜控制是通过逐层切除癌灶区域，并利用冰冻切片系统地在显微镜下检查每一层的整个底面来实现的。组织层可以在用氯化锌对组织进行预先化学固定后切除（固定组织技术），或者在注射局部麻醉剂后以新鲜、未固定的状态切除（新鲜组织技术）。固定组织技术适用于侵犯骨结构内部或周围的广泛、复杂的癌症，侵犯阴茎勃起组织的癌症以及黑色素瘤。新鲜组织技术适用于几乎所有其他皮肤癌。显微镜控制带来的双重优势，首先是保证根除癌症，包括其临床上不可预测的分支，其次是最大程度地保留正常组织。手术风险较低，因为不使用全身麻醉且患者可保持活动状态。无论通过二期愈合还是即时或延迟修复，组织愈合情况都良好。显微镜控制以及该方法的其他技术优势，将手术可操作性扩展到了一些患有广泛且复杂癌症的患者，而对于缺乏这种控制的方法，这些患者几乎没有治愈的可能。最终，所有大型人口中心都应配备使用微控手术的设施和经过培训的人员。
