title: Impact of low-thermal-injury devices on margin status in laryngeal cancer. An experimental ex vivo study.
abstract: BACKGROUND
  Status of margins significantly affects disease-free survival. This study examines in ex vivo model the effect of thermal-injury on margins status comparing traditional instrument with several low-thermal-injury devices.
  
  
  METHODS
  We conducted a prospective study on 10 excised larynges from patients affected by advanced laryngeal cancer, to assess the thermal-effect due to surgical incisions made at standard distance by using: scalpel, CO2 Laser, harmonic scalpel and electrocautery. Upon histopathological examination, thermal damage (Surgical Artifact, SA), tissue lost/retraction (Shrinkage, S), and tissue alterations were compared for each instrument.
  
  
  RESULTS
  Low-thermal-injury devices increased SA mean value from 800.7 to 11447.85 μm (72%), and S mean value from 2.226 to 2.910 mm (68.4%) (p<0.05).
  
  
  CONCLUSIONS
  The choice of surgical device could influence the histopathological margins status, consequently affecting post operative therapeutic strategies and risk of recurrence.
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy. Electronic address: mannelli.giuditta@gmail.com.
authors.forename: Giuditta
authors.initials: G
authors.lastname: Mannelli
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Meccariello
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Deganello
authors.affiliation: Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Viale G.B. Morgagni, 85, 50134 Florence, Italy.
authors.forename: Vincenza
authors.initials: V
authors.lastname: Maio
authors.affiliation: Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Viale G.B. Morgagni, 85, 50134 Florence, Italy.
authors.forename: Daniela
authors.initials: D
authors.lastname: Massi
authors.affiliation: First Clinic of Otolaryngology, Department of Surgery and Translational Medicine, University of Florence, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Gallo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011446:Prospective Studies
keywords: HNSCC; Low thermal injury devices; Margin status; Thermal tissue damage