How We Improve the Transoral Resection for Oral and Oropharyngeal Cancer: the CO Waveguide Laser

Overview

Journal Eur Arch Otorhinolaryngol

Specialty Otorhinolaryngology

Date 2019 May 23

PMID 31115687

Citations 4

Authors

G Tirelli

F Boscolo Nata

R Bussani

A Gatto

E Quatela

S Rigo

M Piovesana

Affiliations

Soon will be listed here.

Abstract

Purpose: The main aim of this study was to evaluate the CO waveguide laser (CO 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: CO 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.

Citing Articles

What's behind Margin Status in Oral Cancer?.

Piovesana M, Boscolo Nata F, Gardenal N, Tofanelli M, Boscolo-Rizzo P, Bussani R Indian J Otolaryngol Head Neck Surg. 2024; 76(5):5001-5007.

PMID: 39376299 PMC: 11455710. DOI: 10.1007/s12070-024-04943-x.

The role of NBI with flexible video-endoscope in the follow-up of head and neck cancer patients: a prospective study.

Boscolo Nata F, Gardenal N, Giudici F, Tirelli G Eur Arch Otorhinolaryngol. 2021; 279(4):2133-2141.

PMID: 34304298 DOI: 10.1007/s00405-021-07016-9.

Histological Effects of an Innovative 445 Nm Blue Laser During Oral Soft Tissue Biopsy.

Palaia G, Pergolini D, DAlessandro L, Carletti R, Del Vecchio A, Tenore G Int J Environ Res Public Health. 2020; 17(8).

PMID: 32294912 PMC: 7215754. DOI: 10.3390/ijerph17082651.

An alternative to skin graft for superficial surgical defect in oral cancer surgery.

Tirelli G, Tofanelli M, Piccinato A, Boscolo Nata F Braz J Otorhinolaryngol. 2020; 87(6):678-682.

PMID: 32247765 PMC: 9422448. DOI: 10.1016/j.bjorl.2020.02.002.

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