A comparison of histopathological results of conventional surgery and transoral radiofrequency ablation in early stage laryngeal carcinoma

Abstract

Objectives: This study aims to compare histopathological results of conventional surgery and transoral radiofrequency ablation in patients with early stage laryngeal carcinoma. Patients and Methods: Between January 2006 and May 2010, 36 patients 34 males, 2 females; mean age 61.6 years; range 43 to 77 years who underwent partial laryngectomy in our clinic were retrospectively analyzed. All patients were randomized to partial laryngectomy with radiofrequency ablation or conventional surgery. Hoarseness due to early stage T1 and selected T2N0 vocal cord lesions was an indication for surgery. Of 20 patients receiving conventional surgery, 14 underwent partial laryngectomy, while six patients underwent cordectomy for the excision of tumors. Tumors were excised by transoral radiofrequency ablation in 16 patients. Results: We observed thermal artifacts in four patients undergoing conventional surgery and in 13 patients undergoing transoral radiofrequency ablation. There was also hemorrhage in 16 patients undergoing conventional surgery and in seven patients undergoing transoral radiofrequency ablation. Histopathological examination revealed that the surgical margins were safe in 10 patients after radiofrequency ablation. The specimens obtained from six patients showed thermal artifacts which complicated histopathological examination. Sixteen 80% of 20 conventional surgery patients and nine 56% of 16 radiofrequency ablation patients had safe surgical margins. Conclusion: In radiofrequency ablation, the surgical zone must be larger than in conventional surgery due to the high risk of tissue damage and complicated histopathological examination.

Keywords

• Laryngeal carcinoma, partial laryngectomy, radiofrequency ablation, surgical zone, transora

Erken evre larenks karsinomunda konvansiyonel cerrahi ve transoral radyofrekans ablasyonunun histopatolojik sonuçlarının karşılaştırılması

Abstract

Amaç: Bu çalışmada erken evre larenks karsinomlu hastalarda konvansiyonel cerrahi ve transoral radyofrekans ablasyonunun histopatolojik sonuçları karşılaştırıldı.Hastalar ve Yöntemler: Ocak 2006 - Mayıs 2010 tarihleri arasında kliniğimizde parsiyel larenjektomi yapılan 36 hasta 34 erkek, 2 kadın; ort. yaş: 61.6 yıl; dağılım: 43-77 yıl retrospektif olarak incelendi. Hastaların tümü radyofrekans ablasyonu ile birlikte parsiyel larenjektomiye veya konvansiyonel cerrahiye randomize edildi. Erken evre T1 ve seçilmiş T2N0vokal kord lezyonlarına bağlı ses kısıklığı, cerrahi endikasyonuydu. Konvansiyonel cerrahi uygulanan 20 hastanın 14’ünde parsiyel larenjektomi, altısında kordektomi ile tümörler eksize edildi. On altı hastada ise transoral radyofrekans ablasyon ile tümörler alındı.Bulgular: Konvansiyonel cerrahi yapılan dört hastada ve transoral radyofrekans ablasyon uygulanan 13 hastada termal artefaktlar gözlendi. Konvansiyonel cerrahi yapılan 16 hastada ve transoral radyofrekans ablasyon uygulanan yedi hastada ise kanama vardı. Histopatolojik incelemede radyofrekans ablasyonundan sonra 10 hastada cerrahi sınırların güvenli olduğu tespit edildi. Altı hastadan alınan örneklerde, histopatolojik incelemeyi güçleştiren termal artefaktlar izlendi. Konvansiyonel cerrahi yapılan 20 hastanın 16’sında 80% ve radyofrekans ablasyonu uygulanan 16 hastanın dokuzunda %56 cerrahi sınırlar güvenli bulundu.Sonuç: Yüksek doku hasarı ve zorlaşmış histopatolojik inceleme riski nedeniyle, radyofrekans ablasyonunda, konvansiyonel cerrahiye kıyasla, cerrahi alan daha geniş olmalıdır

Keywords

• Larenks karsinomu, parsiyel larenjektomi, radyofrekans ablasyonu, cerrahi alan, transoral

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