Mohs micrographic surgery is a specialized technique used to treat complex 皮肤癌. 它提供了最高的回收率, 新发皮肤癌的治愈率为99%复发性皮肤癌的治愈率为95%, 即使其他治疗方法都失败了.
莫氏显微手术
与标准程序相比, Mohs surgery removes the smallest amount of healthy tissue, which minimizes scarring and preserves skin function and appearance. 除了, local anesthesia is used at the tumor site, eliminating the risks associated with general anesthesia.
十大赌博靠谱网络平台处理
Mohs micrographic surgery is used to treat complex 基底细胞癌和鳞状细胞癌. 在某些情况下,它用于治疗不太常见的肿瘤,包括一些浅表肿瘤 黑素瘤.
Skin cancers are considered complex in the following instances:
- 癌细胞所在的部位对维持人体皮肤功能和外貌至关重要,而在这个部位保存健康的组织, 比如眼睑, 鼻子, 耳朵, 嘴唇和手.
- 癌症发生在肿瘤复发率高的部位,如耳朵、嘴唇、鼻子、眼睑和太阳穴.
- 癌症没有得到完全治疗,或者以前接受过治疗并复发.
- 癌细胞很大.
- Edges of the cancer cannot be clearly defined.
- Scar tissue exists in the area of the cancer.
- Cancer is growing in an area previously treated by radiation therapy.
- The patient is immunosuppressed, such as those who have had an 器官移植,都是 艾滋病毒阳性 或有 慢性淋巴细胞白血病.
- 由于遗传综合症等情况,患者有患多种皮肤癌的风险, basal cell nevus syndrome or xeroderma pigmentosa.
准备
手术前, 术前咨询我们的专家团队,以确定莫氏手术是否是最好的治疗选择. 如果你住得离加州大学旧金山分校医疗中心很远,或者你的转诊十大赌博平台排行榜熟悉莫氏手术,可以和你详细讨论,你可能不需要术前咨询.
When your appointment for surgery is scheduled, 我们的护士协调员将与您联系,讨论您的病史和您正在服用的任何药物.
Mohs surgery is usually completed on an outpatient basis, meaning there's no overnight stay in the hospital. Please follow these instructions prior to surgery:
- Before your surgery, get a good night's rest and eat breakfast.
- 在手术前24小时内洗个澡,用洗发水洗头,尽量减少皮肤上的细菌生长,防止感染.
- Please arrive 30 minutes before your appointment to register. A map of UCSF Medical Center and travel instructions will be provided.
- 带上你的保险资料和办理手续所需的任何保险表格. 大多数保险计划包括费用,但请在手术前与你的保险公司确认.
- Plan on being at UCSF for most of the day. 带一本书或杂志来阅读.
- Arrange for someone to drive you home after your surgery. If possible, ask a friend or family member to accompany you to UCSF.
过程
在莫氏手术中,组织被手术切除并精确地“绘制”其位置.手术当天,外科十大赌博平台排行榜会在显微镜下仔细检查组织. 在这个过程中, 在修复皮肤之前,要对肿瘤周围100%的组织边缘进行评估,以确保肿瘤被完全切除. 结果是, 莫氏手术对复杂皮肤癌的治愈率最高,同时最大限度地减少了正常组织的切除.
标准的皮肤癌手术切除检查肿瘤部位周围1%的组织边缘,残留的肿瘤组织可能会被遗漏.
1 .麻醉
Local anesthesia is used around the tumor site to numb the area. General anesthesia is not required for Mohs surgery.
步骤2 -切除肿瘤
皮肤完全麻木后, the tumor is gently scraped with a curette, 一个semi-sharp, scoop-shaped仪器. This helps define the margin between tumor cells and healthy tissue. 第一层薄薄的碟状组织由外科十大赌博平台排行榜通过手术切除. An electric needle may be used to stop bleeding. This process takes about 10 to 20 minutes.
步骤3 -绘制肿瘤
在一层组织被移除之后, a "map" or drawing of the tissue and its orientation to "landmarks,“比如鼻子或脸颊, is made as a guide to the precise location of the tumor. 组织被标记和颜色编码,以与它在地图上的位置相关联.
组织切片经过处理,然后由外科十大赌博平台排行榜检查,以评估是否有残留癌细胞的证据. It takes about an hour to process, stain and examine a tissue section. 在这个过程中,你的伤口会包扎起来,你可以离开手术室了.
步骤4 -确保癌细胞被清除
If any section of the tissue shows cancer cells at the margin, the surgeon returns to that specific area, 如地图所示, 然后移除另一层薄薄的组织. The removed tissue is again mapped, color-coded, processed and examined. If microscopic analysis still shows evidence of disease, the process continues layer by layer until the cancer is completely removed.
5 .重建
莫氏的外科十大赌博平台排行榜, who have completed fellowship training in the procedure, 皮肤重建专家是否能保持正常的皮肤功能和外观. 手术后修复伤口的最佳方法是在肿瘤完全切除后确定的.
缝线可以用来左右缝合伤口,也可以设计皮肤移植或皮瓣. Sometimes, a wound may be allowed to heal naturally. 在极少数情况下, 当莫氏手术范围极广或切除肿瘤导致功能损害时, we may recommend that you visit one of our plastic surgeons for reconstruction.
复苏
当你的伤口愈合后,请回到你的主治十大赌博平台排行榜那里定期做皮肤检查. 我们建议半年随访两年,如果没有发现其他癌症,以后每年随访一次. If any areas of your skin change in any way, 不能治愈或引起关注, 请立即通知你的十大赌博平台排行榜.
一般来说,手术的耐受性很好,副作用很少,但你可能会遇到以下情况:
疼痛
You will experience little discomfort after your surgery. 病人 who do experience pain take Tylenol. 由于可能导致出血,请不要服用阿司匹林或布洛芬来控制疼痛. In some cases, you may be prescribed a stronger pain medication.
出血
少数患者会出现出血,这通常是通过按压来控制的. 拿一块纱布垫,在出血部位持续按压15分钟. Do not lift up or relieve the pressure during this period of time.
If bleeding persists after continued pressure for 15 minutes, repeat the pressure for another 15 minutes. 如果失败,打电话给你的十大赌博平台排行榜. A doctor can be reached 24 hours a day by calling the answering service. This phone number will be given to you when you leave. 手术后的第一个晚上请不要饮酒,因为这可能会刺激出血.
并发症
Please notify us if you have an increase in your temperature, 发冷, 增加发红, 肿胀, 引流或疼痛加剧.
Minor complications that may occur after surgery include:
- A small red area surrounding your wound may appear. This is normal and does not necessarily indicate infection.
- 伤口周围又痒又红, especially in areas where adhesive tape has been applied, 是常见的. 当这种情况发生时, 请您的药剂师提供非过敏胶带,并让我们知道您回访时发生的情况.
- 可能会出现肿胀和瘀伤,特别是在眼睛周围进行手术时. 这通常会在手术后的4 - 5天内消退,在手术后的前48小时内使用冰袋可以将其最小化.
- At times, the area surrounding your operative site will be numb to the touch. This numbness may persist for several months and can be permanent. If this occurs, please tell your doctor at your follow-up visit.
Scarring can be minimized by the proper care of your wound. We will discuss wound care in detail with you.
预防皮肤癌复发
患皮肤癌后,你将来患皮肤癌的风险更高. Skin damage from the sun cannot be reversed. Here are some precautions that can be taken to prevent further 皮肤癌:
- Apply SPF 30 or higher sunscreen at least 10 minutes before sun exposure.
- 经常补涂防晒霜.
- 避免过度日晒.
- Wear a wide-brimmed hat, long-sleeved shirt and other protective clothing.
- 让你的十大赌博平台排行榜每六个月检查一次你的皮肤,检查手术部位的愈合情况, and to look for the development of additional 皮肤癌.
加州大学旧金山分校健康 medical specialists have reviewed this information. 它仅用于教育目的,并不打算取代您的十大赌博平台排行榜或其他医疗保健提供者的建议. 我们鼓励您与您的供应商讨论您可能遇到的任何问题或疑虑.