皮膚癌最主要的兩種因素

皮膚是人體最大的器官，結構分別為三層，外層是表皮，然後是深層的真皮，其次是皮下組織。而最常見的皮膚癌有三大類，包括基層細胞癌，鱗狀細胞癌，這兩種可統稱為，而第三種則是黑色素細胞癌。另外還有其他的皮膚癌，包括真皮，皮下組織甚少出現癌症的。

現時全球的病發率有不段上升的趨勢，就連香港的病發率遠較西方人低的，也在急速上升。雖然不是所有皮膚癌都是因暴露在陽光下有關，但暴露在紫外光的照射下和皮膚的類型是皮膚癌最主要的兩種因素，所以大家應明白過度曝曬在陽光下的危險及做足預防措施的重要性。而其他會導致皮膚癌的因素有：利用室內太陽燈曝曬，經常接觸化學致癌物，輻射影響或慢性皮膚刺激或發炎等。

基層細胞癌

基層細胞是一種生長較慢而又是最常見的一種皮膚癌，通常發生於頭部，臉上，頸部和手部，男性比女性多，患者的皮膚較白哲，眼珠和毛發通常都較淺色。基底細胞癌從外觀看來是表面光滑的肉粒或肉結，而它轉移到其他部位的機會不大，但癌細胞亦可能往皮膚下延至骨骼，使容貌轉變的。

參考資料: www.genesis-surgery.com

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

割包皮 - 無針局部麻醉技術

無針,無刀割包皮使用噴射注射技術麻醉陰囊和輸精管, 讓割包皮手術於無痛狀態下進行。
噴射注射能有效地將區部麻醉藥迅速進入人體。研究顯示大部份接受割包皮的男士指出無針手術感覺像被像皮圈彈了一下。



過程:

1. 噴射注射技術產生高壓噴霧
2. 形成微細的麻醉的噴霧，彷似針般噴進皮下
3. 噴霧進入陰莖皮膚，產生麻痺的感覺
4. 造成麻醉效果
5. 噴霧會穿透大約4-4.5mm組織
6. 噴霧會擴散~5-6mm
7. 麻醉於約30-45秒產生作用

參考資料:

Yifeng Peng et al., No-Needle Local Anesthesia for Adult Male Circumcision,

The Journal of Urology, 2010; 184, 978-983.

前列腺癌沒有病徵，需要測檢嗎？

毫無疑問，你們許多人可能聽過有關前列腺特異抗原血檢驗的資訊。如果你考慮以前列腺特異抗原血檢驗來篩檢前列腺癌，以下是一些實情讓大家作參考：



大約15至25%患有前列腺癌的男士未必會有高前列腺特異抗原水平。亦即是說，縱使有前列腺癌，檢驗亦未必發現得到。





高前列腺特異抗原水平可以是由其他情況引起，如良性前列腺肥大症、前列腺炎及感染。於有高前列腺特異抗原的男士中，三分之二並沒有前列腺癌。亦即是說，部份人會因而接受不必要的跟進檢查，如針穿刺組織檢查。而這些檢查是有風險的。



前列腺癌並不一定是嚴重的疾病。很多患有前列腺癌的男士沒有明顯病徵和不會因而死亡。這些男士實際不需要治療，相反治療本身可能會有副作用及可能較癌症本身引發更多問題。



因此，與你的外科醫生詳細商討以前列腺特異抗原血檢驗來篩檢前列腺癌的好處及害處是非常重要的。讓他/她協助你在充分理解的情況下去抉擇是否進行檢驗。



當然，我們不應忘記「預防」二字。記住，健康的生活習慣帶來其他健康效益之餘，亦能減低前列腺癌的風險。因此，大家要多吃水果、蔬菜、穀物及穀類食品，並減少進食動物脂肪。













參考資料: www.genesis-surgery.com, www.hkmenshealth.com

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

新甲狀腺手術傷口小

甲狀腺腫瘤患者以女性佔多，雖然可以手術根治，但傳統手術會留下疤痕，令愛美的女士對手術卻步，容易延誤病情。新手術傷口小，可增加患者做手術的決心。



腫瘤會致呼吸困難

25歲的程小姐身體檢查時發現，右甲狀腺有四個數毫米的腫瘤，由於未能證實是否屬惡性，需要一直覆診，最終她選擇了微創手術切除腫瘤。她表示若只有傳統切除手術選擇，會一直覆診，因不想頸上留下難看的疤痕。

外科專科醫生陳東飛表示，甲狀腺位於頸部，出現腫瘤的成因不明，患者以女性佔多，多數是良性腫瘤。由於腫瘤會變大及壓著氣管及食道，患者會出現呼吸困難、吞嚥困難及聲沙等症狀；曾有一名 70歲老翁長有一個直徑六厘米大的甲狀腺瘤，引致呼吸困難，最初誤以為是哮喘，最終發現是甲狀腺腫瘤，要接受切除手術。




儀器不傷乳房組織

傳統甲狀腺切除手術的開刀位置在頸部，部份患者更會因皮膚增生，出現一條約七厘米的蜈蚣狀疤痕，極不美觀。近年微創技術亦應用於甲狀腺切除手術，傷口位置在鎖骨下或胸部，加上傷口長度大減至一厘米，穿衣服已可遮掩疤痕。

最新的甲狀腺微創手術更可將傷口收藏，陳東飛表示，會在患者的乳暈及腋下共開三個小孔，將微創儀器放入，並進行切除手術，患者手術後或會感到乳房麻痹，大部份會在半年後回復。由於手術儀器會在皮膚及肌肉層間經過，並不傷及乳房組織，故不會影響患者日後餵哺母乳，此手術現時適用於直徑五厘米以下的良性腫瘤。



陳東飛 外科專科醫生














參考資料: hk.apple.nextmedia.com

以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向自己的外科醫生查詢，而不應單倚賴以上提供的資料。

ingrown nail surgery (2)

Ingrown nail surgery, ingrown nail procedure

Swelling causes pain when patient walks. In early stages, conventional treatments such as anti-inflammatory drugs, antibiotics, softening toe nails with warm water can relief the symptoms. However, for severe ingrown nails, the cure is to remove the entire nail. Below are several possible treatments:

Remove all ingrown nails: this is the simplest method. Generally one-third of the nail is removed, so no nail remains in the skin and no pain will be felt. But the chance of relapse is up to 80-90%. Factors like nail too close to the edges and nail bed swelling will also affect the effectiveness.

Wedge Resection：

which is to remove the all toe tissues including the nail groove and the nail plate and stich afterwards. Chance of relapse is much lower, but the toenail may be deformed and narrower. Since suture is required, there will be wound and remove the stitches after the surgery.

Chemicals to damage the toenail matrix: apply chemicals on the ingrown nail, which damages the toenail matrix, so as to prevent the growth of the nail. The method is simple but incomplete. Because excess chemicals may cause unnecessary damage on other tissues, but too little may lead to re-growing of nails around nail groove, so ingrown nail will happen again.

Laser：A new ingrown nail surgery in recent years. The method is to remove one-fourth or one-fifth of the nail plate and apply laser to the nail matrix, preventing its growth. Laser also vaporizes the nail bed tissues, so swelling is reduced. This surgery requires local anesthetic and lasts for about 30 minutes. It causes less damage and thus quicker recovery.








Reference information: www.genesis-surgery.com

The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.

ingrown nail surgery (1)

Case sharing

Mr. Chan had experienced the pain of ingrown nail. “Two months ago I felt pain on the right big toe. It was so painful that I could not wear shoes except slippers. I could barely walk. Painkillers are just for temporary uses. It was very disturbing to my life. I couldn’t focus on my work, couldn’t do exercises and couldn’t go out to dine with my friends because of the pain in my toes. Mainly I could only stay home and watch TV. It was very depressing.

His sister experienced the same thing years ago. Her method was to remove the entire toe nail and wait for it to grow back. Mr Chan thinks the reason for his ingrown nail is he cut his nail too deeply, causing new nails inserted into the skin nearby. Now Mr Chan would never do the same thing again.

Causes of ingrown nail

The nail bed under the nail is a very thin layer of skin. Nail is similar to hair, which grows after it is peeled off. Matrix is the origin of the toe nail, which is under the cover of the skin total. Ingrown nail seldom occur in finger nails, usually it happens on the big toe nails, and very few happen on other toe nails, which is usually caused by congenital deformation.

Ingrown nail happens when cutting the toe nail too deeply, so when the nail grows upward, it penetrates the nail total as a sharp blade, causing trauma, leading to bacterial infection and forming pus. Other factors such as wearing high heels, narrow head shoes, will all increase pressure on the toes, causing swelling. And sweaty feet will increase moisture and worsen the problem of ingrown nail.

Reference information: www.genesis-surgery.com

The information aims to provide educational purpose only. Anyone reading it should consult Surgery Specialist before considering treatment and should not rely on the information above.