Comparison of local tumor recurrence following excision with the CO2 laser, Nd:YAG laser, and argon beam coagulator

✍ Scribed by Raymond J. Lanzafame; Kang Qiu; David W. Rogers; John O. Naim; Fred C. Caldwell; Freddy Perry; Darline Hall; J. Raymond Hinshaw

• Publisher: John Wiley and Sons
• Year: 1988
• Tongue: English
• Weight: 515 KB
• Volume: 8
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.1900080511

✦ Synopsis

This study compares the incidence of local tumor recurrence following primary excision with the CO2 laser, Nd:YAG laser (contact), Argon Beam Coagulator, or electrocautery. One hundred eight Fisher 344 rats with R3230AC mammary tumors (1.6 k 0.04 [SD] cm diameter) were used. All animals were randomized into groups of similar tumor size.

In groups C and CS, excision was performed with a Sharplan 1060 COs laser (TEMoo, 25 W, continuous wave [CWI, 0.2-mm spot size). Wounds in group CS were "sterilized" (0.5-mm spot size, 25 W, CW) by gently heating the wound without causing blanching or charring. In group N, a 0.4-mm contact Laser Blade @ and a Cooper So00 Nd:YAG laser at 20 W CW was used. In groups SA1 and SA2, tumors were excised with the scalpel, and hemostasis and wound "sterilization" were accomplished with the Bard System 6000 Argon Ream Coagulator (ABC) at 40 W and 4 liters/min argon gas flow in SA1 and 12 literdmin in SA2. In group E, excision was accomplished at 40 W blend mode, 10 W spray mode. In group EA, excision was accomplished at 60 W cutting current, and hemostasis was achieved with the ABC. The animals were examined for evidence of recurrence for 34 days postoperatively. Mortalities were excluded from analysis. The incidence of recurrence was 11/14 (79%) in C, 6/16 (38%) in CS, 10/14 (71%) in SA1, 6/13 (46%) in SA2, 6/15 (40%) in N, 7/10 (70%) in EA, and 3/15 (20%) in E. Group E is statistically different ( P < .01) from groups EA, C, and SA1. Group C was different ( P < .01) from groups E, CS, and N. These results demonstrate an inverse relationship between tumor recurrence and local thermal effects at the surgical site. The ABC did not increase tumor recurrence. Contact YAG surgery was similar to COP laser excision and "sterilization." An attempt to study the influence of gas flow and pressure on local tumor recurrence and metastases should be made.