Ｍａｌｉｇｎａｎｔ ｍｅｌａｎｏｍａ ｓｔａｇｅ ＩＩＩにおける手術療法

Abstract

We usually perform wide local excision of the primary lesion and prophylactic lymph node dissection on stage III1 cases, while wide local excision and radical lymph node dissection were performed on stage III2, 3 cases. When the lesion is found on the toes and the anterior half of the sole, we usually perform the amputation at the proximal third of the lower leg. Concerning the subungual melanoma, amputation is performed at MP joints. When the lesion is found on the posterior half of the sole, we usually perform the wide local excision. In some cases of stage III2, 3 subtotal integmentectomy or muscles flap technique was applied occasionally. When intransit metastasis are found we do wide local excision of the primary lesion and the subtotal integmentectomy. The primary lesion being found on the axilla, we perform the wide local excision and the axillary lymph node dissection simultaneously. Then we use the latissimus dorsi muscles flap to cover the axillary veins, arteries and nerves, and to make the good bases for the skin graft. When doing the groin dissection, we usually use the sartorius muscles flap to protect a femoral artery, vein and nerves.