Mohs手术联合双侧V-Y皮瓣及光动力治疗鼻部皮肤鳞状细胞癌

Mohs surgery combined with bilateral V-Y flaps and photodynamic therapy in the treatment of nasal skin squamous cell carcinoma

目的探讨Mohs手术联合双侧V-Y皮瓣及光动力治疗鼻部皮肤鳞状细胞癌的效果。方法观察2015年1月—2017年12月治疗并完成随访的12例鼻部皮肤鳞状细胞癌患者,所有患者均采用Mohs手术联合双侧V-Y皮瓣及光动力治疗,记录手术时间、术中出血量、术后并发症以及6个月后随访情况。结果手术时间70～168 min,中位手术时间114 min,术中出血量5～30 ml,中位出血量19 ml,患者术后均未出现感染,伤口甲级愈合,术后随访6个月无复发,鼻部外形无移位,患者就医满意度高。结论 Mohs手术联合双侧V-Y皮瓣及光动力治疗鼻部皮肤鳞状细胞癌难度适中,具有出血量少、皮瓣成活率高、术后恢复快、肿瘤复发率低等优点,可作为鼻部皮肤鳞状细胞癌的首选治疗方案。

Objective To investigate the effect of Mohs surgery combined with bilateral V-Y flaps and photodynamic therapy in the treatment of nasal skin squamous cell carcinoma. Methods A total of 12 patients from January 2015 to December 2017 were observed , all the patients were treated with Mohs surgery combined with bilateral V -Y flaps and photodynamic therapy , their operating time , intraoperative bleeding volume , postoperative complications , and the status of follow-up of 6 months were recorded. Results The operating time was 70 -168min , the median operating time was 114min , intraoperative bleeding volume was 5 -30ml , and the median volume was 19ml , no postoperative infection occurred. The wounds healed well after 6 months of follow- up , there was no recurrence , no shift in nasal contour , all the patients were satisfied with the effect of the treatment. Conclusion Mohs surgery combined with bilateral V -Y flaps and photodynamic therapy in the treatment of nasal skin squamous cell carcinoma is moderate difficulty , with less bleeding , high survival rate , quick recovery and low recurrence rate , it can be used as the first choice of nasal skin squamous cell carcinoma.