Monteiro L, Delgado M-L, Garcês F, Machado M, Ferreira F, Martins M, Salazar F, Pacheco J-J
Instituto Universitário de Ciências da Saúde, Rua Central de Gandra, 1317, 4585-116 Gandra PRD, Portugal,
Med Oral Patol Oral Cir Bucal. 2019 Mar 1;24(2):e271-e280. doi: 10.4317/medoral.22819.
We aim to evaluate the presence of histological artefacts in the surgical margins of human oral fibro-epithelial hyperplasias excised with lasers of different wavelengths, and also electrosurgical scalpel and cold scalpel. Moreover, we aim to determine if some of these instruments could impair the normal histological diagnosis of these lesions.
We included 130 consecutive surgical samples of 80 females and 50 males (mean age of 53.82±16.55) with a histological diagnosis of an oral benign fibrous-epithelial hyperplasias. The samples were categorized into 6 groups according to the type of instrument used: CO2 laser group, diode laser group, Er:YAG laser group, Nd:YAG laser group, electrosurgical scalpel group and cold scalpel group. Histological instrument-induced changes were microscopic evaluated and related with clinical and pathological variables.
The instrument with highest tissue damage extension (TDE) was the electrosurgical scalpel (1002.2µm±434.92), followed by diode laser (913.73 µm±322.45), Nd:YAG (899.83µm±327.75), CO2 laser (538.37µm±170.50), Er:YAG laser (166.47µm±123.85), and at last with fewer alterations the cold scalpel group (2.36µm±7.27) (P < 0.001). The most regular incision was observed in CO2 laser group, followed by Er:YAG laser, Nd:YAG laser, electrosurgical scalpel and diode laser group with the less regular incision using cold scalpel as comparison (P < 0.001). A correlation was found between the incision score and TDE (P < 0.001). Regarding histological diagnosis, no case showed any limitation of diagnosis related with the use of any instrument evaluated.
Our results suggest that lasers can be used for the excision of oral benign fibrous-epithelial hyperplasias, without hispathological diagnosis limitations, as long as the physical properties of each laser are known and respected. Er:YAG laser have shown to be a laser with few tissue damage extension and with good incision regularity, been a possible instrument of choice for the surgical removal of these lesions.
我们旨在评估使用不同波长激光、电外科手术刀和冷手术刀切除的人类口腔纤维上皮增生手术切缘中组织学伪像的存在情况。此外，我们旨在确定这些器械中的某些是否会损害这些病变的正常组织学诊断。
我们纳入了130例连续的手术样本，其中80例女性和50例男性（平均年龄5
