Where to draw the line: the error in marking surgical excision margins defined
Where to draw the line: the error in marking surgical excision margins defined
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DOI：
10.1016/s0007-1226(03)00203-0
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发表时间：
2003-09-01
期刊：
影响因子：
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通讯作者：
Griffiths, RW
中科院分区：
文献类型：
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作者：
Lalla, R;Brown, TL;Griffiths, RW
我们研究了标记周围皮肤病变切除手术边缘的准确性，以评估是否百分比误差会因边缘测量的不同增量而有所不同。在设计一个实验来验证这一假设时，不同经验的外科医生（n = 19）在纸上画的标准圆形病变周围标记出2、5和10毫米的切除边缘。使用手术标记，尺子和放大镜都是允许的，每个切缘尝试五次。对于2、5和10 mm切缘，发现的错误率分别为35%、14%和4%（与外科医生的等级无关）。在志愿者皮肤上重复实验表明，对于2、5和10毫米的边缘，百分比误差为45%、16%和8%（显著大于纸上的相应误差，在所有情况下p < 0.001）。这些发现表明，对于这些手术标记的边缘，术语“准确切除边缘”可能在很大程度上是不准确的。本研究明确了手术边缘标记固有的错误，在评估报告肿瘤周围边缘的研究时应考虑到这些错误。特别地，比较手术和组织学边缘将有助于评估详细报道皮肤肿瘤周围手术边缘的报告。(C) 2003年英国整形外科医师协会。Elsevier Ltd.出版。版权所有。
We studied the accuracy of marking surgical margins for excision surrounding skin lesions, to assess if the percentage error would differ for varying increments in margin measurements. In designing an experiment to test this hypothesis, surgeons of differing experience (n = 19) marked excision margins of 2, 5 and 10 mm around a standard circular lesion drawn on paper. Use of surgical markers, rulers and loupe magnification were all permitted, with five attempts for each margin. The percentage error found was 35, 14 and 4% for the 2, 5 and 10 mm margins, respectively (regardless of the grade of surgeon).Repetition of the experiment on volunteer skin demonstrated a percentage error of 45, 16 and 8% for 2, 5 and 10 mm margins (significantly greater than the corresponding errors on paper, p < 0.001 in all cases).These findings indicate that for these surgically marked margins, the term 'accurate excision margins' may be inaccurate to a significant degree. This study has defined the errors inherent in the marking of surgical margins, and these should be taken into account when assessing studies that report margins around tumours. Specifically, comparisons between surgical and histological margins would aid assessment of reports detailing surgical margins dawn around skin tumours. (C) 2003 The British Association of Plastic Surgeons. Published by Elsevier Ltd. All rights reserved.