Adverse Psychological Events Associated With Mohs Micrographic Surgery: A Rapid Review and Meta-Analysis.

[BACKGROUND] Anxiety and other psychological symptoms may not be addressed in Mohs micrographic surgery (MMS) informed consent procedures nor assessed during the perioperative period.

[OBJECTIVE] First, to examine psychological adverse events (AEs) associated with MMS, and second, to examine psychological risks identified in MMS informed consent forms.

[MATERIALS AND METHODS] This review was registered (PROSPERO CRD42024594453). First, MEDLINE and PsycINFO were searched from inception through November 5, 2024 for studies of adults undergoing MMS with quantitative measures of psychological status in the perioperative period. Thirteen measures, most often of anxiety, were standardized for pooled analysis. Second, Google was searched for US MMS consent forms on October 23, 2024. Data were extracted with 20% conducted in duplicate; authors were contacted for missing data. Risk of bias was assessed.

[RESULTS] The literature search resulted in 29 studies totaling 6,455 patients. Using one standardized score per study, patients reported a pooled distress rating of 25.26 out of 100, with significant heterogeneity (95% confidence interval, 11.44‒61.11, I2 = 100%). The consent form search resulted in 20 consent forms: none listed psychological risks.

[CONCLUSION] Psychological AEs of MMS are common and should be addressed as risks in informed consent processes.