Microscopically controlled surgery

Under microscopic controlled surgery (MKC) refers to the method of operation of a particular skin cancer .

This procedure is used particularly for skin tumors on the face or on the acra , especially for basalioma and spinalioma . These tumors often continue to grow in depth even below the clinically recognizable parts, so that a complete removal is often not possible, especially in the case of larger tumors with single excision.

The principle of microscopically controlled surgery is that the clinically visible part of the skin tumor is excised without the wound being closed afterwards. Instead, only a temporary wound covering, e.g. B. performed with a grease bandage . The removed specimen is then marked with a thread and color. The scheme of the dial of a clock is used: in general, the upper edge is equated with “12 o'clock” and a thread marking is also made there. The position of "12 o'clock" is also marked with a small incision on the wound. Often, a color mark is also made on the cut edge or on the wound base. This marking of the specimen enables precise alignment in the histological laboratory.

The specimens are usually fixed in formalin solution overnight and specially cut open the next morning in the histological laboratory so that in particular the side margins and the base of the specimen can be examined. Information is then passed on to the surgeon as to whether the side margins and the base are tumor-free or whether parts of the tumor can still be seen. In this case, the division analogous to the dial enables the surgeon to continue cutting specifically at those points where tumor cell clusters are suspected. This method is then used until the tumor has also been completely excised histologically. Only then is the final wound closure made.

The advantage of microscopically controlled surgery is that the tumor is neither operated too closely and thus the likelihood of recurrence is lower, nor is the tumor excised too generously, which complicates the subsequent wound closure, especially in the face. In addition, the cosmetic-aesthetic requirements can also be better taken into account in this way. The disadvantage today is that the implementation is tied to special centers, v. a. at dermatological clinics, and that patients are often still hospitalized for surgery in order to reduce the risk of wound infections and secondary bleeding .

Individual evidence

1. ↑ Microscopically controlled surgery for malignant skin tumors at aerzteblatt.de, accessed on May 13, 2016.
2. ↑ Microscopically controlled surgery (MKC) at derma.de, accessed on May 13, 2016.

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