Nevüs Eksizyonunda Endikasyonlar, Histopatolojik Korelasyon ve Hasta Tarafından Bildirilen Sonuçlar: Prospektif Gözlemsel Bir Çalışma

Öz

Amaç: Melanositik nevüsler, melanositlerin en yaygın iyi huylu büyümeleri arasındadır. Genellikle iyi huylu olmalarına rağmen, bu lezyonlar estetik kaygılar, malignite (kötü huylu hastalık) korkusu, semptomatik lezyonlar, fiziksel müdahale veya hasta tercihi gibi çeşitli klinik ve hasta odaklı endikasyonlar nedeniyle sıklıkla eksize edilir. Bu çalışma; nevüs eksizyonu endikasyonlarını tanımlamayı, hasta tarafından bildirilen sonuçları sistematik olarak değerlendirmeyi, cerrahi karar verme sürecini optimize etmeyi, terapötik planlamayı geliştirmeyi ve plastik cerrahide bireyselleştirilmiş, hasta odaklı bakımın ilerlemesine katkıda bulunmayı amaçlamaktadır. Yöntemler: Bu çalışma, prospektif gözlemsel bir çalışma olarak tasarlanmıştır. Çalışma, Ağustos 2025 ile Ekim 2025 tarihleri arasında aynı klinik ortamda yürütülmüştür. Çalışmaya 18 ile 85 yaşları arasında toplam 154 yetişkin hasta dahil edilmiştir. Eksize edilen her nevüs için endikasyonlar, histopatolojik tanılar ve hasta memnuniyeti her bir eksizyon için kaydedilmiştir. Memnuniyet, 1 aydan uzun süreli takipte Sayısal Derecelendirme Ölçeği (NRS 1–10) kullanılarak değerlendirilmiştir. Bulgular: Hastaların ortanca yaşı 35’ti (IQR: 28–45). Prosedürlerin çoğunluğu (n=169, %65,8) estetik nedenlerle gerçekleştirildi. Patoloji, 181 vakanın (%70,4) intradermal nevüs olduğunu ortaya koydu. Genel klinikopatolojik uyum %81,7 olarak saptandı. En düşük memnuniyet kozmetik eksizyonlarda gözlemlenirken (ortalama puan: 8.38±1.78), en yüksek memnuniyet hastanın malignite korkusu nedeniyle yapılan eksizyonlarda kaydedildi (ortalama puan: 9.63±0.96) (p = 0.007). Sonuç: Nevüs eksizyonu genel olarak yüksek memnuniyet sağlasa da, estetik vakalarda puanlar daha düşüktür; bu nedenle, hasta beklentilerini cerrahi sonuçlarla uyumlu hale getirmek için kapsamlı ameliyat öncesi danışmanlık esastır.

Anahtar Kelimeler

• Estetik
• Hasta memnuniyeti
• Nevüs
• Skar

Etik Beyan

Bu araştırma için etik kurul onayı, Ankara Bilkent Şehir Hastanesi Tıbbi Araştırmalar Bilimsel ve Etik Değerlendirme Kurulu No. 2’den alınmıştır (tarih: 06/08/2025, karar no: 2-25-1286).

Indications, Histopathological Correlation, and Patient-Reported Outcomes in Nevus Excision: A Prospective Observational Study

Öz

Objective: Melanocytic nevi are among the most common benign growths of melanocytes. Although usually benign, these lesions are frequently excised for a variety of clinical and patient-centered indications, including aesthetic concerns, fear of malignancy, symptomatic lesions, physical interference, or patient preference. This study aims to define the indications for nevus excision, systematically evaluate patient-reported outcomes, optimize surgical decision-making, improve therapeutic planning, and contribute to advancing individualized, patient-centered care in plastic surgery. Methods: This study was designed as a prospective observational study. The study was conducted in the same clinical setting between August 2025 and October 2025. A total of 154 adult patients aged 18 to 85 years were included in the study. For each excised nevus, indications, histopathological diagnoses, and patient satisfaction were recorded for each excision. Satisfaction was evaluated at >1 month follow-up using a Numeric Rating Scale (NRS 1–10). Results: The median age of patients was 35 (IQR: 28–45). The majority of procedures (n=169, 65.8%) were conducted for aesthetic reasons. Pathology revealed that 181 cases (70.4%) were intradermal nevi. Overall clinicopathological concordance was 81.7%. The lowest satisfaction was observed in cosmetic excisions (mean score: 8.38±1.78), while the highest was noted in excisions performed due to patient fear of malignancy (mean score: 9.63±0.96) (p = 0.007). Conclusion: While nevus excision yields high overall satisfaction, scores are lower in aesthetic cases; thus, comprehensive preoperative counseling is essential to align patient expectations with surgical outcomes.

Anahtar Kelimeler

• Cicatrix
• Esthetics
• Nevus
• Patient satisfaction

Etik Beyan

Ethical approval was obtained for this research from the Medical Research Scientific and Ethical Evaluation Board No. 2 of Ankara Bilkent City Hospital (date: 06/08/2025, decision no: 2-25-1286).

Kaynakça

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