NDYAG LASER SCALPEL COMPARED WITH CONVENTIONAL TECHNIQUES IN HEAD ANDNECK-CANCER SURGERY

Many theoretical advantages over conventional surgical techniques have been attributed to the Nd:YAG contact laser. Clinically significant d ifferences in perioperative results between the Nd:YAG contact laser a nd standard surgery, however, are not well defined. The present study was undertaken to evaluate the Nd:YAG contact laser compared with stan dard scalpel and/or electrocautery in curative operations for head and neck cancer. Clinical records of 36 patients undergoing head and neck cancer surgery were reviewed retrospectively. Patients were studied i n three groups: 9 previously irradiated patients operated upon using t he Nd:YAG laser (Nd:YAG); 9 previously irradiated patients operated up on using conventional techniques (conventional/RT); 18 nonirradiated p atients operated upon using conventional techniques (conventional/no R T). These groups underwent 14,14, and 25 procedures, respectively. Dif ferences between the Nd: YAG, conventional/RT, and conventional/no RT groups regarding cancer staging, age, procedures performed, operative time, intraoperative blood loss, and hospital and ICU stay were not st atistically significant. Preoperative radiotherapy dosages in the Nd:Y AG and conventional/RT groups were similar (5,127 +/- 842 vs. 604 +/- 2,373 cGy). Postoperative morbidity in Nd:YAG patients (11%) was simil ar to that of the conventional/no RT group (17%) and was significantly reduced compared to conventional/RT (11% vs. 56%, P < 0.05). Clinical outcome, including operative time, blood loss, and hospital and ICU s tay using the Nd: YAG contact laser in curative operations on previous ly irradiated patients with head and neck cancer, is equal to that of conventional surgical techniques, with or without preoperative radioth erapy. Among patients operated upon after receiving radiation therapy for head and neck cancer, the Nd:YAG contact laser significantly reduc es postoperative morbidity. The data indicate that the Nd:YAG contact laser is an effective surgical technique in head and neck oncology. (C ) 1994 Wiley-Liss, Inc.