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传统手术与二氧化碳激光治疗口腔内软组织病变的比较及对附带热损伤的评估

Comparison of conventional surgery and CO2 laser on intraoral soft tissue pathologies and evaluation of the collateral thermal damage.

作者信息

Tuncer Ibrahim, Ozçakir-Tomruk Ceyda, Sencift Kemal, Cöloğlu Sedat

机构信息

University of Yeditepe, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey.

出版信息

Photomed Laser Surg. 2010 Feb;28(1):75-9. doi: 10.1089/pho.2008.2353.

DOI:10.1089/pho.2008.2353
PMID:19715451
Abstract

OBJECTIVE

The aim of the study was to compare conventional surgery with carbon dioxide (CO(2)) laser applied on oral soft tissue pathologies and to evaluate the effect of collateral thermal damage on histopathological diagnosis. Anesthesia need, postoperative pain, and intraoperative and postoperative complications were examined as part of the comparison.

METHODS

Forty-three patients (32 female and 11 male) with a mean age of 54 (54 +/- 7.0) requiring soft tissue surgeries were randomly assigned to receive treatment either with conventional surgery using a scalpel or with a CO(2) laser technique. Anesthesia method and need, postoperative pain, systemic pain medications if needed, and intra- and postoperative complications were recorded. Excised tissues were evaluated histopathologically for the effect of thermal damage.

RESULTS

All patients were anesthetized with local anesthesia in the conventional group whereas only 10 (42%) patients needed local anesthesia after topical anesthetic application in the laser group. In the conventional group, 18 (90%) patients need analgesics after the operation, compared with seven (29%) patients in the laser group. No intra- or postoperative complications were seen for either procedure. Histological examination of 39 specimens showed that collateral thermal damage on the incision line did not affect the histopathological diagnosis.

CONCLUSIONS

CO(2) laser is an effective instrument for soft tissue excisional biopsies with minimal intraoperative and postoperative complications and good pain control. CO(2) laser applications are suggested as an alternative method to conventional surgery on oral soft tissues.

摘要

目的

本研究旨在比较传统手术与应用于口腔软组织病变的二氧化碳(CO₂)激光,并评估附带热损伤对组织病理学诊断的影响。作为比较的一部分,还检查了麻醉需求、术后疼痛以及术中和术后并发症。

方法

43例(32例女性和11例男性)平均年龄为54岁(54±7.0)需要进行软组织手术的患者被随机分配接受使用手术刀的传统手术或CO₂激光技术治疗。记录麻醉方法和需求、术后疼痛、必要时的全身止痛药物以及术中和术后并发症。对切除的组织进行组织病理学评估以确定热损伤的影响。

结果

传统组所有患者均采用局部麻醉,而激光组仅10例(42%)患者在局部麻醉剂应用后需要局部麻醉。传统组有18例(90%)患者术后需要镇痛药,而激光组为7例(29%)患者。两种手术均未观察到术中和术后并发症。对39个标本的组织学检查表明,切口线上附带的热损伤不影响组织病理学诊断。

结论

CO₂激光是一种用于软组织切除活检的有效器械,术中和术后并发症极少,疼痛控制良好。建议将CO₂激光应用作为口腔软组织传统手术的替代方法。

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