Outpatient setting very safe for skin cancer surgery

Durham, N.C. -- Mohs micrographic surgery, a common technique used to remove skin cancers, is very safe when performed in an outpatient setting, according to a study published in the Feb. 17, 2003, issue of the Archives of Dermatology. The researchers said their results counter the arguments of legislators, lobbyists and others who question the overall safety of outpatient surgeries.

"It is concerning as a physician to see lobbyists and policy makers openly criticize medical practice without the benefit of data to support their arguments," said study lead author Jonathan Cook, M.D., director of dermatologic surgery at Duke University Medical Center.

The study, conducted by Cook and resident physician Jennifer Perone, M.D., assessed rates of complications associated with 1,343 outpatient Mohs procedures performed at Duke during 2000. The overall complication rate was 1.64 percent, or 22 complications out of the 1,343 surgeries. Thus, said the researchers, the complication rate is low enough to conclude that performing Mohs surgery on an outpatient basis does not represent an undue risk.

Mohs surgery, also known as microscopically controlled surgery, was developed by Frederic Mohs, M.D. for the treatment of certain skin cancers. Performed under local anesthesia, the technique combines surgical removal of the skin cancer with immediate microscopic examination of the removed tissue in order to identify any residual cancerous tissue. The surgeon continues the process of removing tissue and studying it under the microscope until all cancer has been removed. Typically, the surgeon then reconstructs the surgical wound by using a variety of repair techniques.

The Mohs technique has the highest cure rate of all skin cancer treatment methods, and involves the surgical removal of the least amount of tissue possible in order to adequately treat the cancer.

"Of course, any surgical procedure has to be performed in a supervised setting," sa

Contact: Laura Sawyer Brinn or Amy Austell
Duke University Medical Center

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