. 2015; 49(4): 238-245 | DOI: 10.4274/turkderm.86619 | |||
How to perform Mohs micrographic surgery?Gonca ElçinHacettepe Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıklar Anabilim Dalı, Ankara, TürkiyeA considerable number of dermatolologist in Turkey perform standard surgical excision of non-melanoma skin cancer and repair the defects functionally and cosmetically. It is possible to appropriately treat most basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) with standard excision and even with curettage and electrodessication. However, for a group of patients at high risk of recurrence, standard excision cannot provide the desired oncologic cure rates. In order to increase the possibility of oncologic cure, it is recommended that high risk BCCs and SCCs should be excised with larger than 4-6 mm safety margins. On the other hand the most common localization for BCCs and SCCs are the face, and using safety margins larger than 4-6 mm on the face might contradict with the principles of tissue-preserving surgical approach. A more unfavorable situation is that the oncologic cure rates remain below 80% for high-risk BCC and SCC even after standard excisions with safety margins of wider than 4-6 mm. The goal of Mohs micrographic surgery is complete tumor removal with maximum preservation of healthy tissue.. Mohs micrographic surgery is a staged surgery that enables 100% assessment of the entire lateral and deep surgical margins microscopically in minutes after excision with horizontally cut frozen sections for residual cancer. Thus, it increases the oncologic cure rate especially for a certain group of patients with high-risk BCC and SCC. The aim of this paper was to review the Mohs technique, the most thorough method for treating BCC and SCC. Keywords: Mohs surgery, basal cell carcinoma, squamous cell carcinoma, dermatologic surgical procedures, skin neoplasmsMohs mikrografik cerrahisi nasıl uygulanır?Gonca ElçinHacettepe Üniversitesi Tıp Fakültesi Deri ve Zührevi Hastalıklar Anabilim Dalı, Ankara, TürkiyeÜlkemizde melanom dışı deri kanserlerinin standart eksizyonunu ve oluşan defektin fonksiyonel ve kozmetik onarımını yapan azımsanmayacak sayıda dermatolog bulunmaktadır. Standart eksizyon, hatta küretaj ve elektrodesikkasyon yöntemleri ile çoğu bazal hücreli karsinom (BHK) veya skuamöz hücreli karsinom (SHK) uygun şekilde tedavi edilebilir. Rekürrens açısından yüksek risk taşıyan bir grup hastada ise standart eksizyon istenilen onkolojik kür oranlarını sağlayamamaktadır. Onkolojik kür ihtimalini artırmak için yüksek riskli BHK ve SHK’nın standart eksizyonunun 4-6 mm’den daha geniş güvenlik sınırlarıyla yapılması önerilmektedir. Buna karşılık BHK ve SHK sıklıkla yüze yerleşmektedir ve bu alana yerleşen Gonca Elçin. How to perform Mohs micrographic surgery?. . 2015; 49(4): 238-245 Corresponding Author: Gonca Elçin, Türkiye |
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