Safety, complications and patients’ acceptance of Mohs micrographic surgery under local anaesthesia: results from the U.K. MAPS (Mohs Acceptance and Patient Safety) Collaboration Group

Abstract

Mohs micrographic surgery (MMS) is recognized as the goldstandard treatment for high-risk nonmelanoma skin cancers (NMSC) of the head and neck. Given the rising incidence of skin cancer, the past two decades have seen a rapid increase in the number of centres providing this service in the U.K. However, data on the safety, complication rates and patient acceptance of MMS in the U.K. are lacking. Over a 3-month period (September to November 2012) eight regional MMS centres collected data that included tumour site, number of stages to clearance, method of reconstruction and intra-and postoperative complications. In addition to collecting basic demographic and medical information, patients were also asked to rate, on a 10-point Likert scale, (i) their perceived anxiety levels preoperatively, (ii) how well they tolerated the surgery on the day, and (iii) when followed up, their overall acceptance of having undergone MMS under local anaesthesia (LA). Data on 565 patients were analysed. There were 278 women and 287 men, with a median age of 67 years (range 28-93 years). The majority of lesions treated were NMSC (98%). The average number of stages to tumour clearance was 1Á3 (range 1-5). Overall, 60% of patients were clear of tumour within one stage and 34% in two stages, with 6% requiring three or more stages. On average, patients were able to leave the department a little over 4 h after commencing treatment. In total, 88% of all reconstructions (including large flaps and interpolated flaps) were performed on the day by the Mohs surgeon. No major peri-or postoperative complications occurred. Although trouble-

Differences of Mohs micrographic surgery in basal cell carcinoma versus squamous cell carcinoma

“…Our study shows that the rate of complications is low but more frequent when treating SCC than BCC. As previously reported, we have found that perioperative bleeding is the most common adverse event …”

“…Mohs micrographic surgery is a very safe procedure with a very low rate of perioperative adverse events. Most of the complications are minor, such as bleeding, site infection, and end‐skin necrosis/dehiscence, which are the most common complications described . Our study shows that the rate of complications is low but more frequent when treating SCC than BCC.…”

“…Most of the complications are minor, such as bleeding, site infection, and end-skin necrosis/dehiscence, which are the most common complications described. [36][37][38][39] Our study shows that the rate of complications is low but more frequent when treating SCC than BCC. As previously reported, we have found that perioperative bleeding is the most common adverse event.…”

Cirugía micrográfica de Mohs en Uruguay: primeros 130 casos en carcinomas cutáneos

“…Nuestros registros muestran una prevalencia de CBC por sobre CEC; sin embargo, encontramos una cantidad de CEC superior a la esperada (32%) al comparar con otros estudios similares (3,54% -5,64%) (11,(13)(14)(15) . En cuanto a los tipos histopatológicos de los carcinomas, Leibovitch y colaboradores reportan que los subtipos histopatológicos más frecuentes de CBC fueron el infiltrante con 30,7%, luego el nódulo-quístico con 24,2% y el superficial con 13,6% (10) .…”

“…Hussain y colaboradores reportan una incidencia de complicaciones menores de 7,78% en sus CMM, las cuales fueron de características similares a las vistas en nuestros pacientes (15) . El seguimiento al año de la cirugía fue completado en 54%, con un tiempo promedio de 386 días (rango: 9 días a 40 meses).…”