|Tipo di tesi||Tesi di laurea magistrale|
|Titolo||Analisi statistica di 1000 Non Melanoma Skin Cancer del distretto testa-collo: creazione di un algoritmo ricostruttivo chirurgico|
|Titolo in inglese||Statistical analysis of 1000 head and neck Non Melanoma Skin Cancer: generation of a surgical reconstructive algorithm|
|Struttura||Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze|
|Corso di studi||MEDICINA E CHIRURGIA (D.M.270/04)|
|Data inizio appello||2016-10-04|
|Disponibilità||Accesso limitato: si può decidere quali file della tesi rendere accessibili. Disponibilità mixed (scegli questa opzione se vuoi rendere inaccessibili tutti i file della tesi o parte di essi)|
|Data di rilascio||2056-10-04|
Non Melanoma Skin Cancer (NMSC) è il tumore maligno più comune nella popolazione caucasica, con un'incidenza crescente annua nel corso dei decenni.
Non Melanoma Skin Cancer (NMSC) is the most common malignancy occurring in the Caucasian population with an annual increasing incidence over the decades. With the term NMSC all cutaneous cancers that do not involve melanocytes are included, encompassing basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (SCC), but also cutaneous lymphomas, adnexal tumors, Merkel cell carcinoma and other rare tumors. BCCs and SCCs are the most common and account for more than 95% of all NMSC. Treatments are mainly distinguished in surgical and topical, depending on the tumor criteria of high or low risk for recurrences or metastasization. Surgery is preferable in all those conditions whereas topical therapies are not indicated and can be considered as the gold standard therapy for the management of SCCs. Surgical margins of resection are defined according to international guidelines: in low risk BCCs and SCCs a 5 mm margin is required to achieve the 95% chance of clearance, whereas in high risk tumors (diameter > 2 cm or particular locations) a minimal margin of 10 mm is required. Reconstruction procedures are fundamental to ensure a good clinical outcome. These include skin grafting, local and free flaps, primary closure, healing by secondary intention (SIH) and the use of dermal substitutes and depend on the ability of the surgeon and the intrinsic characteristics of the surgical breach. The present study has been carried out at the Department of Dermatologic Surgery of Modena. The aim of the study is to provide a critical revision of our surgical experience in order to evaluate the surgical behavior and to describe a reconstructive algorithm to help guide the surgeon in determining the optimal reconstruction in NMSC of head and neck from a cosmetic and functional point of view. Surgical anatomy, considerations for patient and technique selection, reconstructive goals, as well as the reconstructive ladder, are also discussed. Size, anatomical location, radiation history, previous surgery, a full consideration of surgical techniques, and a detailed appraisal of patient factors and expectations are important factors in determining the ideal reconstruction. The simplest surgical technique should be used whenever possible to provide the most functional and aesthetic reconstruction, with the least amount of complexity.