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Shave Excision (shave + excision)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Surgical approach to benign small papular and dome-shaped melanocytic naevi on the face

JOURNAL OF COSMETIC DERMATOLOGY, Issue 3-4 2003
U Tursen
Summary Patients frequently request removal of benign papular and dome-shaped naevi for cosmetic or functional reasons. Melanocytic naevi can be removed by elliptical, round, punch or shave excision or destroyed using electrodessication or cryotherapy. Total elliptical excision is probably the most widely used method of removal. If malignancy is suspected, adequate specimens for histological interpretation are required. When malignancy is not suspected, the cosmetic result becomes the first priority. Smaller incisions minimize tissue trauma and so give cosmetically superior results. Round excision has been recommended for the removal of moles but has not been widely practised. Round excision and punch excision may be better alternatives than conventional fusiform excision of benign dome-shaped or papular naevi of the face, as more tissue is preserved. Shave excision of naevi may be preferable to elliptical excision in sites where the incidence of hypertrophic scarring is high, as preservation of some thickness of the dermis may result in a more acceptable scar or even avoid a scar entirely. Expedient and simple surgery with excellent cosmetic results can be accomplished by the use of punches. Cryotherapy with cutting or curetting and electrodesiccation combined with shaving have been described. Round excision may be a better alternative to conventional fusiform or shave excision of benign papular or dome-shape nevus of the face because it leaves an almost imperceptible scar. In this technique, less skin is excised and histopathological examination can be done. [source]

Aerodigestive Tract Invasion by Well-Differentiated Thyroid Carcinoma: Diagnosis, Management, Prognosis, and Biology

THE LARYNGOSCOPE, Issue 1 2006
Judith Czaja McCaffrey MD
Objectives/Hypothesis: 1) To describe the clinical entity invasive well-differentiated thyroid carcinoma (IWDTC), 2) to determine prognostic factors for survival in patients with IWDTC, 3) to describe and compare types of surgical resection to determine treatment efficacy, 4) to offer a staging system and surgical algorithm for management of patients with IWDTC, 5) to examine alterations in expression of E-cadherin and ,-catenin adhesion molecules in three groups of thyroid tissue and propose a cellular mechanism for invasion of the aerodigestive tract. Study Design: Basic science: quantification of expression of E-cadherin and ,-catenin in three groups of thyroid tissue. Clinical: retrospective review of patients with IWDTC surgically treated and followed over a 45-year time period. Methods: Basic science: immunohistochemical staining was used with antibodies against E-cadherin and ,-catenin in three groups of tissue: group 1, normal control thyroid tissue (n = 10); group 2, conventional papillary thyroid carcinoma (n = 20); group 3, IWDTC (n = 12). Intensity scores were given on the basis of protocol. One-way analysis of variance (ANOVA) was used to evaluate differences between groups. Post hoc ANOVA testing was completed. P < .05 was significant. Clinical: patients were divided into three surgical groups within the laryngotracheal subset: group 1, complete resection of gross disease (n = 34); group 2, shave excision (n = 75); group 3, incomplete excision (n = 15). Cox regression analysis was used to determine significance of prognostic factors. Kaplan-Meier plots were used to evaluate survival. P < .05 was significant. Results: Basic science: a significant difference between the three thyroid tissue groups for E-cadherin expression was demonstrated on one-way ANOVA testing. When controls were compared with either experimental group in post hoc ANOVA testing, differences between all groups were demonstrated (P < .001). For ,-catenin, the intensities of the three groups were not different by one-way ANOVA testing. Similar nonsignificant results were found on post hoc ANOVA testing. Clinical: there was a statistically significant difference in survival for patients with and without involvement of any portion of the endolarynx or trachea (P < .01). There was a significant difference among all three surgical groups when compared (P < .001). When complete and shave groups were compared with gross residual group there was a significant decrease in survival in incomplete resection group (P < .01). Cox regression analysis demonstrated invasion of larynx and trachea were significant prognostic factors for poor outcome. The type of initial resection was significant on multivariate analysis. Removal of all gross disease is a major factor for survival. Conclusions: Basic science: there is a decrease in membrane expression of E-cadherin in IWDTC, and loss of this tumor suppressor adhesion molecule may contribute to the invasive nature of well-differentiated thyroid carcinomas. Clinical: laryngotracheal invasion is a significant independent prognostic factor for survival. Patients undergoing shave excision had similar survival when compared with those undergoing radical tumor resection if gross tumor did not remain. Gross intraluminal tumor should be resected completely. Shave excision is adequate for minimal invasion not involving the intraluminal surfaces of the aerodigestive tract. [source]

Surgical approach to benign small papular and dome-shaped melanocytic naevi on the face

JOURNAL OF COSMETIC DERMATOLOGY, Issue 3-4 2003
U Tursen
Summary Patients frequently request removal of benign papular and dome-shaped naevi for cosmetic or functional reasons. Melanocytic naevi can be removed by elliptical, round, punch or shave excision or destroyed using electrodessication or cryotherapy. Total elliptical excision is probably the most widely used method of removal. If malignancy is suspected, adequate specimens for histological interpretation are required. When malignancy is not suspected, the cosmetic result becomes the first priority. Smaller incisions minimize tissue trauma and so give cosmetically superior results. Round excision has been recommended for the removal of moles but has not been widely practised. Round excision and punch excision may be better alternatives than conventional fusiform excision of benign dome-shaped or papular naevi of the face, as more tissue is preserved. Shave excision of naevi may be preferable to elliptical excision in sites where the incidence of hypertrophic scarring is high, as preservation of some thickness of the dermis may result in a more acceptable scar or even avoid a scar entirely. Expedient and simple surgery with excellent cosmetic results can be accomplished by the use of punches. Cryotherapy with cutting or curetting and electrodesiccation combined with shaving have been described. Round excision may be a better alternative to conventional fusiform or shave excision of benign papular or dome-shape nevus of the face because it leaves an almost imperceptible scar. In this technique, less skin is excised and histopathological examination can be done. [source]

The management of thyroid carcinoma invading the larynx or trachea,

THE LARYNGOSCOPE, Issue 4 2010
Jimmie Honings MD
Abstract Objectives/Hypothesis: To describe the controversies in the management of thyroid carcinoma invading the airway. Study Design: Contemporary review of literature; level of evidence: 5. Results: Invasion of the larynx or trachea by thyroid carcinoma is uncommon and often identified at the time of operation, when the surgeon must decide the extent of resection. Invasion of the airway is associated with loss of tumor differentiation and a reduction in long-term survival compared to tumors limited to the thyroid gland. Whether or not the invaded airway should be resected remains controversial. Tangential shave excision of tumor is commonly performed, despite a marked risk of local recurrence. Circumferential sleeve resection of the larynx and trachea is safe and lowers the risk of local recurrence. In recurrent disease, laryngotracheal resection provides effective palliation of airway obstruction and hemoptysis. Conclusions: Long-term (>10,20 years) prospective studies are required to compare the outcome after shave excision with segmental airway resection for thyroid carcinoma. Based on the current literature and on our experience, we advocate circumferential tracheal resection in the setting of airway involvement. Laryngoscope, 2010 [source]

Aerodigestive Tract Invasion by Well-Differentiated Thyroid Carcinoma: Diagnosis, Management, Prognosis, and Biology

THE LARYNGOSCOPE, Issue 1 2006
Judith Czaja McCaffrey MD
Objectives/Hypothesis: 1) To describe the clinical entity invasive well-differentiated thyroid carcinoma (IWDTC), 2) to determine prognostic factors for survival in patients with IWDTC, 3) to describe and compare types of surgical resection to determine treatment efficacy, 4) to offer a staging system and surgical algorithm for management of patients with IWDTC, 5) to examine alterations in expression of E-cadherin and ,-catenin adhesion molecules in three groups of thyroid tissue and propose a cellular mechanism for invasion of the aerodigestive tract. Study Design: Basic science: quantification of expression of E-cadherin and ,-catenin in three groups of thyroid tissue. Clinical: retrospective review of patients with IWDTC surgically treated and followed over a 45-year time period. Methods: Basic science: immunohistochemical staining was used with antibodies against E-cadherin and ,-catenin in three groups of tissue: group 1, normal control thyroid tissue (n = 10); group 2, conventional papillary thyroid carcinoma (n = 20); group 3, IWDTC (n = 12). Intensity scores were given on the basis of protocol. One-way analysis of variance (ANOVA) was used to evaluate differences between groups. Post hoc ANOVA testing was completed. P < .05 was significant. Clinical: patients were divided into three surgical groups within the laryngotracheal subset: group 1, complete resection of gross disease (n = 34); group 2, shave excision (n = 75); group 3, incomplete excision (n = 15). Cox regression analysis was used to determine significance of prognostic factors. Kaplan-Meier plots were used to evaluate survival. P < .05 was significant. Results: Basic science: a significant difference between the three thyroid tissue groups for E-cadherin expression was demonstrated on one-way ANOVA testing. When controls were compared with either experimental group in post hoc ANOVA testing, differences between all groups were demonstrated (P < .001). For ,-catenin, the intensities of the three groups were not different by one-way ANOVA testing. Similar nonsignificant results were found on post hoc ANOVA testing. Clinical: there was a statistically significant difference in survival for patients with and without involvement of any portion of the endolarynx or trachea (P < .01). There was a significant difference among all three surgical groups when compared (P < .001). When complete and shave groups were compared with gross residual group there was a significant decrease in survival in incomplete resection group (P < .01). Cox regression analysis demonstrated invasion of larynx and trachea were significant prognostic factors for poor outcome. The type of initial resection was significant on multivariate analysis. Removal of all gross disease is a major factor for survival. Conclusions: Basic science: there is a decrease in membrane expression of E-cadherin in IWDTC, and loss of this tumor suppressor adhesion molecule may contribute to the invasive nature of well-differentiated thyroid carcinomas. Clinical: laryngotracheal invasion is a significant independent prognostic factor for survival. Patients undergoing shave excision had similar survival when compared with those undergoing radical tumor resection if gross tumor did not remain. Gross intraluminal tumor should be resected completely. Shave excision is adequate for minimal invasion not involving the intraluminal surfaces of the aerodigestive tract. [source]

Pyogenic granuloma complicating pulsed-dye laser therapy for cherry angioma

AUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2009
Sheryn Cheah
ABSTRACT A 37 year-old-woman presented for cosmetic removal of a 7-mm (diameter) cherry angioma on her right anterior thigh. Various treatment options were discussed and removal of the lesion using pulsed-dye laser was carried out. The patient returned 5 weeks later complaining of bleeding from the treatment site, which on examination showed a 23 × 23-mm friable nodular lesion with the typical appearance of a pyogenic granuloma. This lesion was removed by shave excision, curettage and electrodessication. Histopathological examination confirmed the diagnosis of pyogenic granuloma. This is a rare occurrence post pulsed-dye laser therapy that physicians may choose to discuss with patients prior to performing this procedure. [source]

Treatment options for giant congenital naevi

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 1 2000
Lawrence
Giant congenital naevi (GCN) are disfiguring, potentially malignant pigmented naevi present at birth. The naevus cells in GCN are found throughout the dermis and sometimes penetrate the subcutaneous septa. It is claimed that superficial, more heavily pigmented and biologically different naevus cells reside in the upper dermis. Partial removal of these superficial naevus cells by dermabrasion, laser therapy, curettage or shave excision is less traumatic than excision surgery and produces an acceptable cosmetic result. However, none of these techniques or excision of GCN to superficial fat completely removes the risk of malignant transformation. [source]

Sebaceous gland carcinoma of the eyelid presenting as a conjunctival papilloma

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 2 2005
Jwu Jin Khong MB BS (Hons)
Abstract An unusual presentation of sebaceous carcinoma of the eyelid is described in a 96-year-old man who presented with a large papillomatous palpebral conjunctival lesion in the left upper eyelid. The patient underwent a shave excision of the lesion, followed by a full thickness excision with paraffin section margin control. Histopathology revealed a sebaceous gland carcinoma with no evidence of pagetoid spread. Although rare, sebaceous gland carcinoma should be considered in the differential diagnosis of a conjunctival papilloma. [source]