Department of Sense Organs, Sapienza University of Rome, 00186, Rome, Italy.
Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00186, Rome, Italy.
Lasers Surg Med. 2020 Apr;52(4):301-306. doi: 10.1002/lsm.23142. Epub 2019 Jul 23.
Transoral laser microsurgery (TLM) is a universally recognized safe and minimally invasive approach for early glottic cancer. Narrow band imaging (NBI) is an optical technique working with a filtered light that reveals superficial mucosal abnormalities through the neoangiogenic pattern. The aim of this systematic review is to demonstrate the role of intraoperative NBI during TLM for early glottic cancer to better evaluate tumor extension and for more precise margin resection.
STUDY DESIGN/MATERIALS AND METHODS: A systematic review of the literature following the PRISMA guidelines was performed. A literature search was performed using the following keywords: TLM, NBI, and early glottic cancer. Two independent authors evaluated the extracted data. Data regarding status of surgical margins after TLM, local recurrence, recurrence-free survival, and need of additional samples following NBI were collected.
Five articles met inclusion criteria with a total of 577 patients undergoing TLM with intraoperative NBI. A significant reduction of positive superficial margins was found in patients treated with (52%) and without (28.6%) intraoperative use of NBI (P < 0.05) CONCLUSIONS: Routine use of intraoperative NBI increases the accuracy of neoplastic superficial spreading evaluation and accuracy of mass resection during TLM for early glottic cancer. The significant reduction of superficial positive margins dramatically decreases the number of patients at risk and improves clinical outcomes. Lasers Surg. Med. © 2019 Wiley Periodicals, Inc.
经口激光显微手术（TLM）是一种公认的安全、微创的早期声门型癌症治疗方法。窄带成像（NBI）是一种光学技术，使用滤光片通过新生血管模式揭示表面黏膜异常。本系统评价的目的是证明 NBI 在 TLM 治疗早期声门型癌症中的作用，以更好地评估肿瘤的扩展范围，并进行更精确的边缘切除。
研究设计/材料和方法：按照 PRISMA 指南进行系统文献回顾。使用以下关键词进行文献检索：TLM、NBI 和早期声门型癌症。两名独立的作者评估了提取的数据。收集了 TLM 后手术边缘状态、局部复发、无复发生存率以及 NBI 后是否需要额外样本的相关数据。
符合纳入标准的有 5 篇文章，共 577 例患者接受了 TLM 联合术中 NBI 治疗。与未使用术中 NBI（28.6%）的患者相比，使用术中 NBI（52%）的患者浅层阳性边缘的比例显著降低（P<0.05）。
常规使用术中 NBI 可提高 TLM 治疗早期声门型癌症时肿瘤表面扩散评估的准确性和肿块切除的准确性。浅层阳性边缘的显著减少大大降低了患者的风险，并改善了临床结果。激光外科学杂志。© 2019 年 Wiley 期刊出版公司
