title: Review and proposal of regional surgical management for melanoma: revisiting of integumentectomy and incontinuity dissection in treatment of skin melanoma.
abstract: BACKGROUND
  Past studies showed that integumentectomy and incontinuity could be effective procedures in the surgical management of melanoma patients. The present study reports on the historical background of these procedures. In addition, we analyze the ICG assisted integumentectomy and incontinuity techniques and algorithms that we had created when performing this procedure.
  
  
  METHODS
  In accordance with our algorithm, we performed ICG assisted integumentectomy/incontinuity procedures on 17 patients with stage III melanomas between 2008 and 2016. We also investigated the locoregional recurrence rate in a control group comprising 60 patients at stage III without using the algorithm.
  
  
  RESULTS
  The former group exhibited a tendency of locoregional recurrence rate suppression. Melanoma cells in the dissected intervening tissue were microscopically identified in 2 out of 17 cases.
  
  
  CONCLUSIONS
  Our ICG assisted integumentectomy or incontinuity procedures could be effective in controlling locoregional recurrence rates in melanoma cases. Moreover, our method can be generally applied because the dissection is only performed within the lymphatic pathway region identified using indocyanine green.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan. toshi-116@nifty.com.|Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Kita 13, Nishi 7, Kita-ku, Sapporo, 060-8586, Japan. toshi-116@nifty.com.
authors.forename: Toshihiko
authors.identifier: http://orcid.org/0000-0002-1180-1685
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Obihiro-Kosei General Hospital, Nishi 6, Minami 8, Obihiro, 080-0016, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitamura
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Shichinohe
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Murao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oyama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Funayama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D016022:Case-Control Studies; D062109:Dermatologic Surgical Procedures; D004210:Dissection; D005260:Female; D006801:Humans; D007208:Indocyanine Green; D008198:Lymph Nodes / Q000473:pathology; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods; D000096142:Cutaneous Malignant Melanoma
chemical_list: D007208:Indocyanine Green
keywords: Discontinuity; Incontinuity; Indocyanine green; Integumentectomy; Locoregional recurrence rate; Melanoma