Argon plasma coagulation (APC) in palliative surgery of head and neck malignancies.
OBJECTIVE
Surgical reduction of bulky disease is an important treatment option in patients with incurable head and neck malignancies. In general, conventional tumor ablation is associated with significant hemorrhage, and the resulting tumorous wound surface entails aftercare problems. Argon plasma coagulation (APC) represents a novel technique providing effective hemostasis and wound sealing. Thus, APC features requirements of particular interest in palliative surgery of the head and neck.


METHODS
Using APC, we performed 18 palliative tumor resections in a series of 8 consecutive patients with recurrent head and neck lesions. Five patients received repeated APC treatment up to five times.


METHODS
APC as non-contact, high-frequency electrosurgery under inert argon plasma atmosphere allows dissection, hemostasis, and desiccation of tumor tissue in a one-step procedure. In consideration of the limited and heterogeneous group of patients, results are interpreted descriptively.


RESULTS
In every case of palliative surgery, APC caused efficient hemostasis, which helped significantly to reduce both time exposure of the operation and intraoperative loss of blood. Only one APC-unrelated complication occurred (transient rhino-liquorrhea), and none of the patients developed postoperative hemorrhage. Finally, APC produced dry and clean wound surfaces facilitating surgical aftercare. The achieved esthetic and functional improvements strengthened the patient's autonomy and social acceptance.


CONCLUSIONS
APC is highly recommended for palliative surgery of head and neck malignancies.
Hauser
Ulrich
U
Department of Otorhinolaryngology, Head & Neck Surgery, Heinrich-Heine-University, Duesseldorf, Germany. hauser@med.uni-duesseldorf.de
Hoffmann
Thomas K
TK
Balló
Hilmar
H
Bier
Henning
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001128:Argon; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D010166:Palliative Care
D001128:Argon