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Laser microsurgery in oncology: indications, techniques, and results of 5-year experience
G Bandieramonte1, F Chiesa, M Lupi
1Surgical Oncology Department, National Tumor Institute, Milano, Italy.
Abstract:
Multidisciplinary collaboration has enabled us to use the CO2 laser in many different surgical fields. The 5-year experience at the National Tumor Institute of Milan is reviewed for the evaluation of short- and medium-term results of 321 laser surgical operations of the lower genital tract, 475 cases of lesions of the larynx and oral cavity, and 246 cases of skin lesions. A unified approach was used as regards safety measures, preoperative evaluation, and rules of application of laser instruments. The reliability of the surgical procedures, the proper selection of the cases, and the low rate of postoperative complications allowed outpatient treatment in 76% of the cases, thus reducing the hospitalization costs. The use of the microscope for laser resections under magnification was recognized to be preferable in routine surgical oncology practice. Short- and medium-term clinical results with laser microsurgery were comparable to those with conventional surgery, especially when precise and conservative removal of periorificial lesions was required.
Insights
The CO2 laser offers reliable surgical outcomes across various specialties, including gynecologic, laryngeal, oral, and skin lesions. This technology facilitates outpatient treatment, reducing costs and demonstrating comparable results to conventional surgery.
Area of Science:
- Surgical Oncology
- Laser Medicine
- Minimally Invasive Surgery
Background:
- Multidisciplinary collaboration has expanded the application of carbon dioxide (CO2) laser technology in diverse surgical fields.
- A unified approach to safety, preoperative assessment, and laser instrument application was established.
Purpose of the Study:
- To evaluate the short- and medium-term results of CO2 laser surgery across multiple anatomical sites.
- To assess the feasibility and efficacy of laser microsurgery in surgical oncology.
Main Methods:
- Review of 5-year experience at the National Tumor Institute of Milan.
- Analysis of 321 lower genital tract, 475 larynx/oral cavity, and 246 skin lesion cases treated with CO2 laser.
- Application of a standardized protocol for laser procedures, including safety and preoperative measures.
Main Results:
- Outpatient treatment was feasible in 76% of cases, significantly reducing hospitalization costs.
- Laser microsurgery with microscopic magnification proved preferable for routine surgical oncology.
- Short- and medium-term clinical outcomes were comparable to conventional surgical methods, particularly for precise periorificial lesion removal.
Conclusions:
- CO2 laser surgery is a reliable and cost-effective option for various lesions.
- Microscopic laser resection is recommended for surgical oncology practice.
- Laser microsurgery achieves results comparable to conventional surgery, especially for delicate procedures.