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Extramammary P aget's disease: S urgical control from the plastic surgery perspective
Author(s) -
Wong David SauYan,
Ko Loretta WingLam,
Cheung TakHong
Publication year - 2016
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12188
Subject(s) - medicine , margin (machine learning) , disease , surgery , extramammary paget's disease , resection , perspective (graphical) , machine learning , computer science , artificial intelligence
Aim: Local recurrence is a common occurrence after surgical treatment for extramammary P aget's disease ( EMPD ). Current approaches have only focused on the narrowest safe margin necessary for local tumour removal. This leaves the multicentric nature of the disease, which also accounts for recurrence, untackled. More extensive excisions, however, would entail reconstruction, which in turn might mean additional morbidity. In the present study, we examined the relationship of reconstruction after resection with treatment outcome and postoperative recovery to look at the feasibility of wide local excision for achieving ‘disease clearance’.Patients and Methods: The records of patients who received surgical treatment for EMPD over a continuous 14‐year period were reviewed. Primary outcome measures were margin clearance, local recurrence, complications and length of hospital stay.Results: Patients requiring reconstruction had better margin clearance and were not associated with more complications or prolonged hospital stay. They did not have more local recurrences, despite having more advanced local disease.Conclusions: Modern reconstructive techniques can supplement wide excisions for EMPD so that there is no need to limit resection extent in order to reduce morbidity. More liberal excisions than the recommended narrowest safe margins should be better able to eradicate disease.