Few data exist to guide the application of Mohs micrographic surgery (MMS) in the pediatric population. We sought to summarize the clinical characteristics of children undergoing MMS, identify challenges that limit the use of MMS in this population, and examine how these challenges can be overcome. A systematic review of PubMed and EMBASE, from inception of databases to November 2, 2019, identified all cases of pediatric skin lesions treated with MMS. A total of 111 patients were included. The median patient age was 11 years (range 6 weeks to 17 years). The most commonly treated tumor was dermatofibrosarcoma protuberans (n = 62), followed by basal cell carcinoma (n = 30). The most common location was the head and neck (n = 34), followed by the trunk (n = 28) and the extremities (n = 23). The most commonly cited challenges in the application of MMS in children included patient cooperation, concerns for the safety of prolonged general anesthesia, availability of a MMS service in the pediatric setting, and access to a histopathology laboratory experienced in MMS sectioning. Many articles did not report specific patient characteristics. Multiple obstacles limit the application of MMS in pediatric patients. This review describes practical methods to circumvent these obstacles to facilitate the appropriate use of MMS in children.

中文翻译：

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儿童莫氏显微手术的系统评价：确定成功应用的挑战和实际考虑因素


很少有数据可以指导莫氏显微手术 (MMS) 在儿科人群中的应用。我们试图总结接受 MMS 的儿童的临床特征，确定限制 MMS 在该人群中使用的挑战，并研究如何克服这些挑战。对 PubMed 和 EMBASE 的系统回顾（从数据库建立到 2019 年 11 月 2 日）确定了所有接受 MMS 治疗的儿童皮肤病变病例。总共包括 111 名患者。患者中位年龄为 11 岁（范围为 6 周至 17 岁）。最常治疗的肿瘤是隆突性皮肤纤维肉瘤 (n = 62)，其次是基底细胞癌 (n = 30)。最常见的部位是头部和颈部 (n = 34)，其次是躯干 (n = 28) 和四肢 (n = 23)。在儿童中应用 MMS 时最常提到的挑战包括患者合作、对长时间全身麻醉安全性的担忧、儿科环境中 MMS 服务的可用性以及进入在 MMS 切片方面经验丰富的组织病理学实验室。许多文章没有报道具体的患者特征。多重障碍限制了 MMS 在儿科患者中的应用。本综述描述了规避这些障碍的实用方法，以促进 MMS 在儿童中的适当使用。