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European Archives of Oto-Rhino-Laryngology

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01-08-2019 | Oral Cancer | Head & Neck

How we improve the transoral resection for oral and oropharyngeal cancer: the CO₂ waveguide laser

Authors: G. Tirelli, F. Boscolo Nata, R. Bussani, A. Gatto, E. Quatela, S. Rigo, M. Piovesana

Published in: European Archives of Oto-Rhino-Laryngology | Issue 8/2019

Abstract

Purpose

The main aim of this study was to evaluate the CO₂ waveguide laser (CO₂ WGL) with flexible fiber (Lumenis, Santa Clara, CA) in the treatment of oral and oropharyngeal cancers specifically focusing on the lateral thermal damage (LTD) induced by this instrument and therefore on the reliability of the analysis of frozen sections collected during margin mapping.

Methods

A total of 48 patients with oral and oropharyngeal cancers from T1 to T4a were prospectively enrolled in the study. We collected data about LTD, pathologic tumor and node stage (pTNM), surgical intervention, kind of reconstruction (no flap, local vs free flap), need for tracheotomy and time of removal, postoperative complications (such as bleeding, mucosal dehiscence, and fistula), need for feeding tube and time of removal.

Results

Mean LTD was 164.7 ± 92.4 μm. Comparing frozen section histology before and after formalin embedding we found 5 true positives, 170 true negatives, 4 false positives and 4 false negatives, with a sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 55.6%, 98%, 55.6%, 98%, and 96.1%, respectively.

Conclusion

CO₂ WGL is a very manageable tool, which allows a precise cut. However, its high costs, the inability to re-use the fibers and its low coagulation capability must be considered.

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Title: How we improve the transoral resection for oral and oropharyngeal cancer: the CO2 waveguide laser
Authors: G. Tirelli
F. Boscolo Nata
R. Bussani
A. Gatto
E. Quatela
S. Rigo
M. Piovesana
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Oral Cancer
CO2 Laser
Thermal Damage
Laser
Oropharyngeal Cancer
Oral Cavity Carcinoma
Published in: European Archives of Oto-Rhino-Laryngology / Issue 8/2019
Print ISSN: 0937-4477
Electronic ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-019-05473-x

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Springer Medicine

How we improve the transoral resection for oral and oropharyngeal cancer: the CO₂ waveguide laser

Abstract

Purpose

Methods

Results

Conclusion

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Abstract

Purpose

Methods

Results

Conclusion

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