The CO 2 waveguide laser with flexible fiber in transoral resection of oral and oropharyngeal cancers: a retrospective cohort study on postoperative and quality of life outcomes.

Autor: Gardenal N; ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy. nicolettagardenal@gmail.com., Rigo S; ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy., Boscolo Nata F; Otorhinolaryngology Unit, Ospedali Riuniti Padova Sud 'Madre Teresa Di Calcutta' Hospital Monselice (Padova)-ULSS, 6 Euganea, Padua, Italy., Fernández-Fernández MM; Department of Otolaryngology, Hospital Universitario Gregorio Marañón, Madrid, Spain., Boscolo-Rizzo P; ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy., Gatto A; ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy., Tirelli G; ENT Clinic, Head and Neck Department, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149, Trieste, Italy.
Jazyk: angličtina
Zdroj: Lasers in medical science [Lasers Med Sci] 2022 Apr; Vol. 37 (3), pp. 1755-1762. Date of Electronic Publication: 2021 Sep 30.
DOI: 10.1007/s10103-021-03430-x
Abstrakt: The aim of this study was to evaluate the CO 2 waveguide laser (WG CO 2 laser) with flexible fiber (Lumenis Ltd., Yokneam, Israel) in the treatment of oral and oropharyngeal cancers, specifically focusing on postoperative outcomes, pain, and quality of life (QoL). Eighty-one patients, 43 women and 38 men, with oral or oropharyngeal cancer who consecutively underwent transoral resection by WG CO 2 laser from August 2015 to April 2020 were retrospectively enrolled. Resections were performed in super pulsed mode with a power setting ranging between 3 and 10 W. Data about frozen sections, reconstruction, complication rate, length of hospital stay, tracheostomy rate and time to decannulation, nasogastric feeding tube rate and time to oral feeding, pain, and QoL were reviewed. Continuous variables were presented as mean and standard deviation. Concordance between intraoperative frozen section examination and definitive histology was calculated using Cohen's K test of agreement. The mean length of hospital stay was 13 days. The feeding tube rate was 81%; the tracheostomy rate was 35%; the feeding tube was left in place for 8 days on average, and the time to decannulation was 9 days. The only complication was a postoperative bleeding in 4 patients. The median postoperative pain score measured by the Numeric Pain Rating Scale on postoperative days 1, 3, and 5 was 0 and there was a constant decrease in painkiller use over the days. The overall mean composite QoL score was 77 ± 14, with excellent results in saliva, taste, pain, and speech domains. Frozen section evaluation had a specificity of 99% and a negative predictive value of 98%. WG CO 2 laser is a good and safe tool for transoral tailored resection of oral and oropharyngeal cancers. It ensures a good overall QoL and guarantees fast recovery and a very low postoperative pain.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)
Databáze: MEDLINE
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