Characterization of Surgical Procedures in the Spanish Mohs Surgery Registry (REGESMOHS) for 2013-2015
de Eusebio Murillo E (1), Martín Fuentes A (2), Ruiz-Salas V (3), Garcés JR (4), Miñano Medrano R (5), López-Estebaranz JL (5), Alonso-Alonso T (6), Rodríguez-Prieto MÁ (6), Delgado Jiménez Y (7), Morales V (8), Redondo Bellón P (9), Manubens-Mercadé E (10), Sanmartín-Jiménez O 11, Guillén Barona C (11), Cabeza R (12), Cano N (12), Toll-Abelló A (13), Navarro Tejedor R (14), Artola Igarza JL (15), Allende Markixana I (16), Alfaro Rubio A (17), Ciudad Blanco C (18), Vázquez-Veiga H (19), Barchino Ortiz L (20), Descalzo MA (21), García-Doval I (21).
(1) Hospital Universitario de Guadalajara, Guadalajara, España.
(2) Hospital Universitario de Guadalajara, Guadalajara, España.
(3) Hospital de la Santa Creu i Sant Pau, Barcelona, España.
(4) Hospital de la Santa Creu i Sant Pau, Barcelona, España; Hospital Quirón Teknon, Barcelona, España.
(5) Hospital Universitario Fundación Alcorcón, Madrid, España.
(6) Complejo Asistencial Universitario de León, León, España.
(7) Clínica Quirón, Madrid, España; Hospital de la Princesa, Madrid, España.
(8) Clínica Quirón, Madrid, España.
(9) Clínica Universitaria de Navarra, Pamplona, España.
(10) Hospital Quirón Teknon, Barcelona, España.
(11) Instituto Valenciano de Oncología, Valencia, España.
(12) Hospital La Zarzuela, Madrid, España.
(13) Hospital del Mar, Barcelona, España.
(14) Hospital de la Princesa, Madrid, España.
(15) Hospital Galdakao, Bizkaia, España.
(16) Hospital Universitario de Cruces, Barakaldo, España.
(17) Hospital de Manises, Valencia, España.
(18) Hospital Gregorio Marañón, Madrid, España.
(19) Complexo Hospitalario Universitario de Santiago, Santiago de Compostela, España.
(20) Hospital La Zarzuela, Madrid, España; Hospital Gregorio Marañón, Madrid, España.
(21) Unidad de Investigación, Fundación Piel Sana, Academia Española de Dermatología, Madrid, España.
The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016.
MATERIAL AND METHODS:
Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications.
Data were available for 1796 operations. The most common tumor treated by MMS was basal cell carcinoma (85.96%), followed by squamous cell carcinoma (6.18%), lentigo maligna (2.81%), and dermatofibrosarcoma protuberans (1.97%). Primary tumors accounted for 66.9% of all tumors operated on; 19.2% of tumors were recurrent and 13.9% were persistent.
The most common previous treatment was surgical. MMS was mostly performed under local anesthesia (86.7% of cases) and as an outpatient procedure (71.8%). The frozen section technique was used in 89.5% of cases.
One stage was needed to achieve tumor-free margins in 56.45% of patients; 2 stages were required in 32.1% of patients, 3 in 7.1%%, 4 in 2.7%, and 5 or more in 1.8%.
The defect was reconstructed by the dermatologist in 98% of patients and the most common technique was flap closure (47.2%). Intraoperative complications were recorded for just 1.62% of patients and the median (interquartile range) duration of surgery was 75 (60-100) minutes.
The characteristics of the patients and tumors treated by MMS are similar to those reported for similar studies in other geographic areas. Lentigo maligna and dermatofibrosarcoma protuberans accounted for a higher proportion of cases in our series, and repair of the surgical defect by a dermatologist was also more common.
Operating times in MMS are not much longer than those reported for other procedures and the rate of intraoperative complications is very low.
CITA DEL ARTÍCULO Actas Dermosifiliogr. 2017 Aug 9. pii: S0001-7310(17)30258-2. doi: 10.1016/j.ad.2017.04.018