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Transoral Robot-Assisted Surgery in Supraglottic and Oropharyngeal Squamous Cell Carcinoma: Laser Versus Monopolar Electrocautery.

Authors :
Benazzo, Marco
Canzi, Pietro
Mauramati, Simone
Sovardi, Fabio
Occhini, Antonio
Maiorano, Eugenia
Trisolini, Giuseppe
Morbini, Patrizia
Source :
Journal of Clinical Medicine; Dec2019, Vol. 8 Issue 12, p2166-2166, 1p
Publication Year :
2019

Abstract

Background: Monopolar electrocautery (EC) is the surgical cutting and haemostatic tool most commonly used for transoral robotic surgery (TORS). The aim of this study was to retrospectively compare EC efficacy in the treatment of patients affected by T1 or T2 oropharyngeal and supraglottic squamous cell carcinomas with the more recently introduced laser fibres. Methods: We considered all TORS patients admitted to our department from January 2010 to June 2019. The outcomes of patients treated with Thulium: yttrium aluminium garnet (YAG) laser (TY-TORS), CO<subscript>2</subscript> laser (CO<subscript>2</subscript>-TORS) and EC (EC-TORS) were analysed in order to assess surgical performances, functional outcomes and postoperative complications. Results: Twenty patients satisfied the enrolling criteria, of which nine underwent laser-TORS, and the remaining 11 underwent EC-TORS. In all candidates, TORS procedures were completed without the need for microscopic/open conversion. Close or positive margins were significantly more frequent in EC-TORS (p = 0.028). A considerable difference was found in overall functional parameters: times of nasogastric tube and tracheostomy removal and time of hospital discharge were significantly shorter in laser-TORS (p = 0.04, p = 0.05, p = 0.04, respectively). Conclusions: Laser-TORS showed better results in comparison with EC-TORS in term of tumour resection margins and patient functional outcomes. Our findings can be justified with the greater tissue thermal damage caused by EC-TORS, despite prospective randomized trials and increased patient numbers being needed to confirm these preliminary conclusions. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
20770383
Volume :
8
Issue :
12
Database :
Complementary Index
Journal :
Journal of Clinical Medicine
Publication Type :
Academic Journal
Accession number :
140942770
Full Text :
https://doi.org/10.3390/jcm8122166