莫氏显微手术正弦显微镜:质谱法是即将到来的术中肿瘤边缘评估工具吗?

L. Chan
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引用次数: 1

摘要

一种特殊的皮肤癌手术,被称为莫氏显微手术(或莫氏手术),是由威斯康星大学耳鼻喉科医生弗雷德里克·莫氏博士发明的。最初的莫氏手术过程,也被称为化学手术,使用一种含氯化锌的化学浆糊在显微镜控制下一层一层地破坏癌组织。该手术随后被修改为目前被广泛接受的形式,即患有某些面部部位的非黑色素瘤皮肤癌、复发性皮肤癌或具有某些侵袭性组织学特征的皮肤癌的患者,将通过分层切除手术治疗,而不会产生氯化锌膏[2]相关的疼痛。目前的方法能够在术中确定癌症的边缘,利用显微镜检查从切除的定向标记皮肤层获得的染色冷冻切片,在那里可以直观地观察到临床癌症,而患者则等待结果。显微镜下在切除的皮肤层边缘发现肿瘤,就需要病人回到手术台上再做一层切除bb0。如果需要,这个过程会重复,直到所有的边缘都没有皮肤癌,这时莫氏外科医生会闭合伤口缺损,通常使用称为皮瓣[4]的邻近组织转移技术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mohs Micrographic Surgery Sine Microscopy: Is mass spectrometry an upcoming intraoperative cancer margin assessment tool?
A special kind of skin cancer surgery, named Mohs micrographic surgery (or Mohs surgery), was invented by a University of Wisconsin Otolaryngologist, Dr. Frederick Mohs [1]. The initial Mohs surgery procedure, also called chemosurgery, employed a zinc chloride-containing chemical paste to destroy cancerous tissue layer by layer under microscopic control [1]. The procedure was subsequently modified to the current and well-accepted form, where patients affected by non-melanoma skin cancers of certain facial locations, recurrent skin cancers, or skin cancers with certain aggressive histologic features would be treated by a layered excisional procedure without the pain associated with zinc chloride paste [2]. The current procedure, with the ability to determine cancer margin in an intraoperative fashion, utilizes microscopic examinations of stained frozen sections obtained from an excised layer of orientation-marked skin where the clinical cancer is visually observed, while the patient waits for the result. Microscopic identification of cancer at the margin of excised skin layer will necessitate the return of the patient to the surgical table for addition layer of excision [3]. The process repeats if needed, until all margins are clear of skin cancer, at which point the Mohs surgeon will close the wound defect, commonly utilizing adjacent tissue transfer technique called flap [4].
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