Does the Use of Computer-Assisted Surgery Affect the Margin Status in Resections of Ameloblastoma?

Computer-assisted surgery (CAS) was implemented rapidly, and recent concerns have been raised regarding its safety and its effect on surgical outcomes. We wanted to understand the impact CAS has on the surgical margin status when used for the resection of ameloblastoma.

We performed a 10-year retrospective cohort study at a single institution. Subjects were identified by surgical logs and chart query. Histopathologic reports were examined for margin status. We compared surgical technique (CAS and non-CAS) with the surgical margin (≤5 mm vs >5 mm). Other variable outcomes included previous treatment, histologic type, time from imaging to surgery, and recurrence. Bivariate analysis was performed to determine significance.

A total of 31 subjects were identified (12 females; 19 males) with a mean age of 34.5 (standard deviation [SD] ± 19.1) years. Fifteen subjects were included in the CAS group and 16 subjects in the non-CAS group. No statistically significant difference was identified between the CAS and non-CAS group when surgical margins were defined as less than or equal to 5 mm and greater than 5 mm (P = .5368). The average distance from surgical margin to lesion was 9.6 mm (SD ± 5.1) in the CAS group and 8.5 mm (SD ± 5.6) in the non-CAS group (P = .2590). However, the non-CAS group had 1 positive margin and a total of 6 margins of less than or equal to 2 mm compared with zero margins of less than or equal to 2 mm in the CAS group (closest margin 3 mm).

The use of CAS and cutting guides based on predetermined surgical margins did not compromise the margin status in surgical resections of ameloblastoma. The use of CAS could potentially decrease the occurrence of close or positive margins.