High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer
BackgroundTransoral laser microsurgery (TLM) for early to intermediate laryngeal squamous cell cancer (SCC) can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the e...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2017-11-01
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| Series: | Frontiers in Oncology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fonc.2017.00282/full |
| _version_ | 1828451221486174208 |
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| author | Francesco Mora Francesco Missale Fabiola Incandela Marta Filauro Giampiero Parrinello Alberto Paderno Palmiro Della Casa Cesare Piazza Giorgio Peretti |
| author_facet | Francesco Mora Francesco Missale Fabiola Incandela Marta Filauro Giampiero Parrinello Alberto Paderno Palmiro Della Casa Cesare Piazza Giorgio Peretti |
| author_sort | Francesco Mora |
| collection | DOAJ |
| description | BackgroundTransoral laser microsurgery (TLM) for early to intermediate laryngeal squamous cell cancer (SCC) can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the efficacy of high frequency jet ventilation (HFJV) in achieving appropriate laryngeal exposure and safe oncologic resection of lesions located in such a position.MethodsWe reviewed the clinical records of 62 patients affected by Tis-T2 SCC of the posterior laryngeal compartment treated by TLM between 02/2012 and 12/2016. The cohort was divided into two groups according to the anesthesiologic technique used: Group A included patients treated using intraoperative infraglottic HFJV, while Group B encompassed patients treated by standard orotracheal intubation. The main outcome was postoperative surgical margin status. Group comparison analysis was performed.ResultsSignificant difference in deep margin status was observed between the two groups: in Group A, the rate of negative deep margins was 86% compared to 56% in Group B (p = 0.04). A trend of better overall and superficial margin control was observed for patients treated using HFJV (Group A), although no statistical significance was achieved.ConclusionUse of HFJV during TLM allows easier and safer management of patients affected by Tis-T2 SCC of the posterior laryngeal compartment, reducing the rates of positive superficial and deep surgical margins. |
| first_indexed | 2024-12-10T23:32:55Z |
| format | Article |
| id | doaj.art-a137d142a97c4ecdac784a3a48fe1033 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-12-10T23:32:55Z |
| publishDate | 2017-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-a137d142a97c4ecdac784a3a48fe10332022-12-22T01:29:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2017-11-01710.3389/fonc.2017.00282293670High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal CancerFrancesco Mora0Francesco Missale1Fabiola Incandela2Marta Filauro3Giampiero Parrinello4Alberto Paderno5Palmiro Della Casa6Cesare Piazza7Giorgio Peretti8Department of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Brescia, Brescia, ItalyDepartment of Anaesthesiology, Ospedale Policlinico San Martino, Genoa, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, Fondazione IRCCS, National Cancer Institute of Milan, University of Milan, Milan, ItalyDepartment of Otorhinolaryngology—Head and Neck Surgery, University of Genoa, Genoa, ItalyBackgroundTransoral laser microsurgery (TLM) for early to intermediate laryngeal squamous cell cancer (SCC) can be technically challenging when adequate exposure of the posterior laryngeal compartment is required due to the presence of the orotracheal tube. The goal of our study was to analyze the efficacy of high frequency jet ventilation (HFJV) in achieving appropriate laryngeal exposure and safe oncologic resection of lesions located in such a position.MethodsWe reviewed the clinical records of 62 patients affected by Tis-T2 SCC of the posterior laryngeal compartment treated by TLM between 02/2012 and 12/2016. The cohort was divided into two groups according to the anesthesiologic technique used: Group A included patients treated using intraoperative infraglottic HFJV, while Group B encompassed patients treated by standard orotracheal intubation. The main outcome was postoperative surgical margin status. Group comparison analysis was performed.ResultsSignificant difference in deep margin status was observed between the two groups: in Group A, the rate of negative deep margins was 86% compared to 56% in Group B (p = 0.04). A trend of better overall and superficial margin control was observed for patients treated using HFJV (Group A), although no statistical significance was achieved.ConclusionUse of HFJV during TLM allows easier and safer management of patients affected by Tis-T2 SCC of the posterior laryngeal compartment, reducing the rates of positive superficial and deep surgical margins.http://journal.frontiersin.org/article/10.3389/fonc.2017.00282/fullhigh frequency jet ventilationtransoral laser microsurgerylaryngeal cancerglottic cancersupraglottic cancersurgical margins |
| spellingShingle | Francesco Mora Francesco Missale Fabiola Incandela Marta Filauro Giampiero Parrinello Alberto Paderno Palmiro Della Casa Cesare Piazza Giorgio Peretti High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer Frontiers in Oncology high frequency jet ventilation transoral laser microsurgery laryngeal cancer glottic cancer supraglottic cancer surgical margins |
| title | High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer |
| title_full | High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer |
| title_fullStr | High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer |
| title_full_unstemmed | High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer |
| title_short | High Frequency Jet Ventilation during Transoral Laser Microsurgery for Tis-T2 Laryngeal Cancer |
| title_sort | high frequency jet ventilation during transoral laser microsurgery for tis t2 laryngeal cancer |
| topic | high frequency jet ventilation transoral laser microsurgery laryngeal cancer glottic cancer supraglottic cancer surgical margins |
| url | http://journal.frontiersin.org/article/10.3389/fonc.2017.00282/full |
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