Giuditta Mannelli1, Giuseppe Meccariello2, Alberto Deganello2, Vincenza Maio3, Daniela Massi3, Oreste Gallo2. 1. First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy. Electronic address: mannelli.giuditta@gmail.com. 2. First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy. 3. Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Viale G.B. Morgagni, 85, 50134 Florence, Italy.
Abstract
INTRODUCTION: Status of margins significantly affects disease-free survival. This study examines in ex vivo model the effect of thermal-injury on margins status comparing traditional instrument with several low-thermal-injury devices. METHODS: We conducted a prospective study on 10 excised larynges from patients affected by advanced laryngeal cancer, to assess the thermal-effect due to surgical incisions made at standard distance by using: scalpel, CO2 Laser, harmonic scalpel and electrocautery. Upon histopathological examination, thermal damage (Surgical Artifact, SA), tissue lost/retraction (Shrinkage, S), and tissue alterations were compared for each instrument. RESULTS: Low-thermal-injury devices increased SA mean value from 800.7 to 11447.85 μm (72%), and S mean value from 2.226 to 2.910 mm (68.4%) (p<0.05). CONCLUSIONS: The choice of surgical device could influence the histopathological margins status, consequently affecting post operative therapeutic strategies and risk of recurrence.
INTRODUCTION: Status of margins significantly affects disease-free survival. This study examines in ex vivo model the effect of thermal-injury on margins status comparing traditional instrument with several low-thermal-injury devices. METHODS: We conducted a prospective study on 10 excised larynges from patients affected by advanced laryngeal cancer, to assess the thermal-effect due to surgical incisions made at standard distance by using: scalpel, CO2 Laser, harmonic scalpel and electrocautery. Upon histopathological examination, thermal damage (Surgical Artifact, SA), tissue lost/retraction (Shrinkage, S), and tissue alterations were compared for each instrument. RESULTS: Low-thermal-injury devices increased SA mean value from 800.7 to 11447.85 μm (72%), and S mean value from 2.226 to 2.910 mm (68.4%) (p<0.05). CONCLUSIONS: The choice of surgical device could influence the histopathological margins status, consequently affecting post operative therapeutic strategies and risk of recurrence.
Authors: Hong Kyu Kim; Young Jun Chai; Hye Yoon Lee; Hoon Yub Kim; Gianlorenzo Dionigi Journal: Ann Surg Treat Res Date: 2018-05-29 Impact factor: 1.859