Histopathological assessment in glossectomy: harmonic shears versus monopolar electrosurgery pilot study

Area of Science:

• Oncology
• Surgical Pathology
• Surgical Technology

Background:

• Partial glossectomy is a surgical procedure for tongue cancer.
• Evaluating surgical techniques is crucial for optimizing patient outcomes.
• Minimizing thermal damage and artifacts is important in surgical specimen analysis.

Purpose of the Study:

• To compare the outcomes and effect sizes of two glossectomy methods: monopolar electrocautery and Harmonic Focus Curved Shears.
• To utilize a grading system and objective micrometer measurements for artifact assessment.
• To gather data for planning a definitive future study.

Main Methods:

• A pilot study involving 19 patients with tongue cancer undergoing partial glossectomy.
• Patients were divided into two groups: monopolar electrocautery (n=11) and Harmonic Focus Curved Shears (n=8).
• Pathologists assessed surgical specimens for margin artifact grade and measured artifact depth in micrometers.

Main Results:

• Artifact depth was significantly smaller with Harmonic Focus Curved Shears (473,939 µm) compared to monopolar electrocautery (765,633 µm) (P < .0001).
• Less cautery/crush artifacts and extravascular blood clots were observed in the Harmonic Focus Curved Shears group.
• No significant difference was found in margin fragmentation or capillary congestion between the groups.

Conclusions:

• Harmonic Focus Curved Shears are associated with reduced artifact depth and less cautery/crush artifact in partial glossectomy compared to monopolar electrocautery.
• These findings suggest potential benefits of Harmonic Focus Curved Shears for preserving tissue integrity during glossectomy.
• This pilot study provides evidence to guide the design of larger clinical trials comparing these surgical modalities.