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S1-Guideline: Microscopically controlled surgery.

Lukas Kofler1,2, Mirjana Ziemer3, Mindaugas Andrulis4

  • 1Department of Dermatology and Center for Dermatologic Surgery, Eberhard-Karls University of Tübingen, Tübingen, Germany.

Journal Der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG
|November 30, 2022
PubMed
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This summary is machine-generated.

Microscopically controlled surgery (MCS) offers precise removal of skin cancers, sparing healthy tissue. This technique is vital for challenging tumor locations and aggressive types, ensuring complete resection and minimizing recurrence.

Area of Science:

  • Dermatology
  • Surgical Oncology
  • Pathology

Background:

  • Microscopically controlled surgery (MCS) encompasses techniques for complete malignant tumor resection while preserving adjacent healthy tissue.
  • Key to MCS is the topographical orientation of excised tissue, enabling precise identification of residual tumor cells.

Purpose of the Study:

  • To outline the principles, indications, and methods of Microscopically Controlled Surgery (MCS).
  • To highlight the importance of interdisciplinary collaboration in MCS procedures.

Main Methods:

  • MCS involves meticulous surgical excision with immediate microscopic examination of tissue margins.
  • Techniques include 3D histology, the horizontal method, and Mohs surgery, all requiring precise tissue mapping.
  • Close collaboration between surgeons, pathologists, and laboratory staff is crucial.

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Main Results:

  • MCS is indicated for malignant skin tumors in difficult locations and aggressive subtypes, including basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma.
  • Evidence supports MCS benefits for tumors like extramammary Paget's disease and cutaneous sarcomas, particularly in reducing local recurrence.
  • MCS ensures complete tumor resection, especially when complex closure techniques are anticipated.

Conclusions:

  • Microscopically controlled surgery (MCS) provides a high rate of complete tumor removal for various skin cancers.
  • The technique is essential for challenging cases, improving patient outcomes by minimizing recurrence and preserving tissue.
  • Successful MCS relies on integrated expertise from surgical, pathological, and laboratory disciplines.