Sankt-Peterburg, St. Petersburg, Russian Federation
Tula, Russian Federation
Russian Federation
UDK 616-006.81.04 Злокачественная меланома. Меланосаркома. Меланокарцинома
The article deals with the problems of surgical treatment of skin melanoma. Modern surgical treatment of skin melanoma includes various surgical interventions: wide excision of primary skin melanoma, amputation of the finger or disarticulation of the phalanx of the finger, resection of the auricle with its reconstruction, and other operations. The paper discusses the importance of assessing the state of regional lymph nodes in skin melanoma to decide whether to perform lymph node dissection. In addition to adequate excision of primary skin melanoma, to ensure the radicalness of surgical treatment, according to indications, lymph node dissection is performed in case of metastatic lesions of regional lymph nodes. A modern approach to detecting latent metastases involves performing a biopsy of sentinel lymph nodes. The information obtained is extremely important not only in assessing the damage to regional lymph nodes, determining the stage of the disease, but also in choosing the tactics of treatment and predicting the course of the tumor. Significant in the work is the conclusion that regional lymph node dissection is performed only in case of metastatic lesions of regional lymph nodes, confirmed morphologically. Accordingly, the best option is to perform regional lymph node dissection simultaneously with excision of primary skin melanoma. Prophylactic lymph node dissection for skin melanoma is not recommended. In conclusion, the latest trends in the surgical treatment of skin melanoma are indicated: an adequate reduction in the indentation and volume of operations when removing primary melanomas, an increase in the role of sentinel lymph node biopsy, the need for morphological verification of lymph node involvement in justifying lymph node dissection, and an increase in the number of metastasectomy.
skin melanoma, wide excision, amputation of the finger, disarticulation of the phalanx of the finger, resection of the auricle, biopsy of sentinel lymph nodes, regional lymph node dissection, metastasectomy
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