Hofauer Benedikt, Knopf Andreas, Strassen Ulrich, Wirth Markus, Mollenhauer Martin, Edenharter Günther, Heiser Clemens
Otorhinolaryngology/Head and Neck Surgery, Klinikum rechts der Isar, Technical University Munich, Germany.
Otorhinolaryngology/Head and Neck Surgery, University of Freiburg, Germany.
Auris Nasus Larynx. 2020 Feb;47(1):148-153. doi: 10.1016/j.anl.2019.05.003. Epub 2019 May 26.
Various techniques are available for the transoral resection of oral and oropharyngeal tumors. The application of radiofrequency proved successful in the resection of pathologies and achieved a good combination of radicality and hemostasis. The objective of this case series it to evaluate the feasibility of radiofrequency-assisted resection of oral and oropharyngeal tumors.
Patients presenting with oral or oropharyngeal tumors eligible for transoral resection were included. The excision was performed with a 4 MHz microsurgical radiofrequency generator using a monopolar needle. Radiofrequency was evaluated with perioperative (bleeding, tissue sticking, coagulation), objective (wound healing, complications) and subjective postoperative parameters (visual analogue scale of pain, impaired food intake, impaired speak). The surgical specimens were examined regarding entity, width of coagulation margins and the quality of the resection margins and compared to laser-assisted resected specimen.
Twenty-five patients were included. 13 patients suffered from benign and 12 patients from malign lesions. Intraoperative bleeding was described as self-limiting in most of the cases and only in some cases the application of additional light pressure was required. Intraoperative tissue sticking was described as none or as resolvable by activation of the radiofrequency generator. Coagulation was limited to the area of resection. No impairment of wound healing or postoperative complications could be observed. Pain, impaired food intake and speak declined steadily. Radiofrequency-assisted resected specimen showed better assessability compared to laser-assisted resected specimen (p < 0.001). Resection margins were predominantly smooth. The width of the coagulation zones was 1593.75 μm on average.
Radiofrequency is a suitable tool for the resection of oral and oropharyngeal tumors with a favourable intraoperative performance regarding the peri-incisional bleeding control and a continuous decline of postoperative morbidity.
经口切除口腔和口咽肿瘤有多种技术可用。事实证明，射频技术在病变切除中取得了成功，并在根治性和止血方面实现了良好的结合。本病例系列的目的是评估射频辅助切除口腔和口咽肿瘤的可行性。
纳入符合经口切除条件的口腔或口咽肿瘤患者。使用4MHz显微外科射频发生器和单极针进行切除。从围手术期（出血、组织粘连、凝血）、客观（伤口愈合、并发症）和主观术后参数（疼痛视觉模拟量表、进食障碍、言语障碍）方面对射频进行评估。对手术标本进行实体、凝血边缘宽度和切除边缘质量检查，并与激光辅助切除标本进行比较。
纳入25例患者。13例为良性病变，12例为恶性病变。大多数病例术中出血为自限性，仅在某些情况下需要施加额外的轻压。术中组织粘连被描述为无或通过激活射频发生器可解决。凝血仅限于切除区域。未观察到伤口愈合受损或术后并发症。疼痛、进食障碍和言语障碍稳步下降。与激光辅助切除标本相比，射频辅助切除标本的可评估性更好（p < 0.001）。切除边缘大多光滑。凝血区平均宽度为1593.75μm。
射频是切除口腔和口咽肿瘤的合适工具，在切口周围出血控制方面具有良好的术中表现，术后发病率持续下降。
