Department of Otolaryngology, Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Tel Aviv Sourasky Medical Center, Institute of Pathology, Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Laryngoscope. 2021 May;131(5):E1514-E1518. doi: 10.1002/lary.29155. Epub 2020 Oct 5.
OBJECTIVES/HYPOTHESIS: The effects of different electrocautery power settings on mucosal contraction and margin status in the oral cavity have not been well established. The aim of this study was to examine how different levels of electrocautery energy outputs affect oral mucosal tissue margins.
Animal model.
A model of 23 adult rats was used (two specimens per rat). After anesthetizing the animals, a 6-mm biopsy punch marked the resection margin on the buccal mucosa (one per cheek). The specimens were excised by means of three energy levels, a cold knife, and monopolar diathermy that was set on either 20 W or 30 W cut modes. The specimens were evaluated for extent of contraction.
A total of 45 samples were obtained and measured, including 15 specimens in the cold-knife group, 15 specimens in the 20 W group, and 15 specimens in the 30 W group. The median diameters of the specimens after resection were 4.5 mm for the cold-knife group (interquartile range [IQR] = 4.0-5.0), 3.5 mm for the 20 W group (IQR = 3.5-4.0), and 2.8 mm for the 30 W group (IQR = 2.5-3.0). Specimen contraction was 25.0%, 41.7%, and 53.3%, respectively. The difference in shrinkage between each pair was statistically significant: cold knife versus 20 W, P = .001; cold knife versus 30 W, P < .0001; and 20 W versus 30 W, P < .001.
Diathermy power settings result in a significant difference of mucosal tissue contraction, with higher outputs resulting in a narrower mucosal margin. It is imperative that the surgical team take into consideration the diathermy settings during initial resection planning. Laryngoscope, 131:E1514-E1518, 2021.
目的/假设：不同电烙功率设置对口腔黏膜收缩和边缘状态的影响尚未得到很好的确定。本研究的目的是研究不同水平的电烙能量输出如何影响口腔黏膜组织边缘。
动物模型。
使用 23 只成年大鼠模型（每只大鼠两个标本）。麻醉动物后，用 6mm 活检穿孔器标记颊黏膜的切除边缘（每侧脸颊一个）。通过三种能量水平、冷刀和单极电烙术（分别设置在 20W 或 30W 切割模式下）切除标本。评估标本的收缩程度。
共获得和测量了 45 个样本，包括冷刀组 15 个标本、20W 组 15 个标本和 30W 组 15 个标本。切除后标本的中位数直径分别为冷刀组 4.5mm（四分位距[IQR]=4.0-5.0）、20W 组 3.5mm（IQR=3.5-4.0）和 30W 组 2.8mm（IQR=2.5-3.0）。标本收缩率分别为 25.0%、41.7%和 53.3%。每对之间的收缩差异均有统计学意义：冷刀与 20W 相比，P=0.001；冷刀与 30W 相比，P<0.0001；20W 与 30W 相比，P<0.001。
电烙功率设置导致黏膜组织收缩程度存在显著差异，输出功率越高，黏膜边缘越窄。手术团队在初始切除计划中必须考虑电烙设置。喉镜，131：E1514-E1518，2021。
