Article

Mechanisms of carbon dioxide laser reduction of tumor recurrence in experimental mammary tumor. (Abstract)

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Abstract

This study compares local tumor recurrence after low energy CO2 laser wound sterilization with recurrence after scalpel, laser or electrocautery excision. Wound histologic changes were studied to understand the mechanism of the interaction between the laser and wound. Single implants of R3230AC mammary tumor were grown to an average diameter of 24 millimeters in the mammary ridge of 80 female fisher 344 rats. Rats were anesthesized with pentobarbital and randomized into groups, each with similar tumor size: scalpel (S), laser (L), laser with wound sterilization (LV), scalpel with sterilization (SV) and electrocautery (E). All surgical procedures were performed by the same surgeon with the same technique, with the exception of the instruments used. Tow rats from each group were sacrificed immediately and the wounds examined histologically. The Sharplan 1100 CO2 laser was used with a 125 millimeter hand piece in focus and in continuous wave for groups L and LV. Sterilization in groups LV and SV was performed with 5 millimeter spot size by heating the site gently without causing blanching of tissue. Excision in group E was performed with coagulating current from a monopolar cautery (Valley Lab). Rats were examined periodically for 30 days and those dying during this period were excluded from analysis. The incidence of wound recurrence was eight of 12 in group S; five of eight, L; four of 13, E; three of 12, LV, and two of nine, SV (p less than 0 .05). Histologic changes in the wound demonstrated viable tumor in all groups, with fewer areas present in groups E, SV and LV. Local thermal effects and the noncontact nature of the CO2 laser make it an effective adjunct in reducing local tumor recurrence by enhancing the cytoreductive capability of surgical procedures.

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... The presence or absence of local recurrence and metastases after primary tumour excision is an important indicator of surgical treatment efficiency.[30][31][32] Tumouricidal effects of laser treatment in oncologic surgery were the subject of several experiments.11,13,14,33 It was assumed that the tumour excision with closure of blood and lymphatic vessels and complete destruction of tumour cells in the path of the laser beam may improve prognosis after surgery.13,14,33 ...
... Tumouricidal effects of laser treatment in oncologic surgery were the subject of several experiments.11,13,14,33 It was assumed that the tumour excision with closure of blood and lymphatic vessels and complete destruction of tumour cells in the path of the laser beam may improve prognosis after surgery.13,14,33 Significantly lower local recurrence rate or the delay of its development after CO 2 laser tumour excision, compared with scalpel surgery, was demonstrated in several experiments performed on rats with implanted adenocarcinoma cells (R323OAC).11,14,33 ...
... It was assumed that the tumour excision with closure of blood and lymphatic vessels and complete destruction of tumour cells in the path of the laser beam may improve prognosis after surgery.13,14,33 Significantly lower local recurrence rate or the delay of its development after CO 2 laser tumour excision, compared with scalpel surgery, was demonstrated in several experiments performed on rats with implanted adenocarcinoma cells (R323OAC).11,14,33 Similarly, experiments performed on mouse tumour models showed a lower local recurrence rate after laser excision and a significantly longer time period between tumour excision and local recurrence development compared with scalpel surgery.12,13 ...
Article
Background: The important goal of modern research in the field of surgical oncology is the quest for a tool that could improve the outcomes of tumour excision. Aims: The aim of this study was to compare the usefulness of the CO2 laser with flexible hollow waveguide and scalpel in mammary tumour excision. Materials & methods: A total of 112 female BALB/c mice with implanted orthotopically 4T1-luc2-tdTomato tumour cells were included in the research. Tumours were excised in 48 mice using the CO2 laser and in 48 through scalpel surgery. The control group consisted of 16 untreated mice. The evaluation of surgical outcome was obtained by in vivo bioluminescence and fluorescence imaging and post-mortem histopathological examination. Results: There were no significant differences between recurrence rates, metastases and survival time in groups excised with the scalpel and CO2 laser. Conclusion: The CO2 laser has similar efficacy compared with conventional scalpel excision for local recurrence rates, incidence of distant metastases and survival time and can be safely applied in oncological surgery.
... As the CO 2 laser is a non-contact application, it also greatly reduces the chance of seeding tumour cells when compared to non-laser surgical excision (Lanzafame et al. 1986;Holt and Mann 2002). A reduction in local tumour recurrence as well as fewer metastases and longer survival rates have been observed in several studies using rodent models to compare excision of tumours with a CO 2 laser to non-laser surgical methods (Tuchmann et al. 1986;Lanzafame et al. 1988). ...
Article
AIMS: To compare the duration of anaesthesia, surgery, and postoperative hospitalisation, the proportion of tumours excised with complete histologic margins and immediate postoperative surgical site complications in dogs undergoing removal of cutaneous or subcutaneous soft tissue sarcomas (STS) by either carbon dioxide (CO2) laser or non-laser surgical excision methods. METHODS: Medical records of dogs that underwent surgical excision of cutaneous and subcutaneous STS at the University of Missouri between December 2004 and May 2018 were evaluated. The study population consisted of client-owned dogs that underwent CO2 laser (n=4) or non-laser (n=20) excision of a single STS. Data recorded included: signalment, duration of anaesthesia, surgery and postoperative hospitalisation, tumour characteristics, completeness of histologic margins, postoperative complications, adjunctive therapy, and other procedures at the time of surgery. RESULTS:. There was no evidence of a difference in mean age, body weight or tumour size between groups. Similarly there was no evidence of a difference in the duration of anaesthesia or surgery, or in the proportion of dogs whose STS were removed with complete histologic margins between dogs whose STS was removed using laser or non-laser surgical excision methods. However, the duration of postoperative hospitalisation trended towards being longer for the laser excision group (p =0.061). CONCLUSIONS: These data provide preliminary evidence that excision of cutaneous or subcutaneous STS with CO2 surgical laser is comparable to non-laser methods for the measured outcomes.
... The CO2 laser is a very precise soft tissue cutter which causes minimal thermal damage to the surrounding tissue and less spreading of tumour cells than surgical instruments. It is therefore used in human and veterinary oncology (Lanzafame and others 1988, Palmer 1989). A success rate of 60 to 80 per cent has been reported when the laser is used both to cut and evaporate the sarcoids (Diehl and others 1987, Vingerhoets and others 1988, Carstanjen and others 1997). ...
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Conference Paper
The results of the effective use of magnetic laser therapy in the treatment and rehabilitation of cancer patients were presented. The effect of magnetic-laser therapy in the treatment of radiation-induced reactions in the patients with head and neck cancer and in the patients with breast cancer was analyzed. High efficiency of lymphedema and lymphorrhea treatment in the postoperative period in the patients with breast cancer was proved. The results of rehabilitation of the patients with gastric cancer after surgical treatment were presented. These data indicate a high effectiveness of different physical methods of treatment and rehabilitation of cancer patients.
... During the 3-month post surgical observation period we noticed local recurrence only in two cases. Lanzafame et al. [11] demonstrated fewer recurrences after CO 2 laser tumor removal compared to conventional scalpel excision. The probable cause of this difference is the sealing of small blood vessels and lymph vessels by the CO 2 laser which prevents tumor cells spreading [3][4][5]. ...
Article
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Breast cancer is an increasingly common problem affecting one in nine women. The optimal management of carcinoma of the breast remains controversial. This paper reviews the rationale for the use of laser technology in the treatment of primary and advanced breast cancer. The CO2 laser has several properties which make it advantageous for breast surgery. The technical details for optimal laser utilization are presented. Experimental evidence documents a marked reduction of local tumor recurrence following surgery with lasers. Preliminary human studies suggest that laser use lengthens the disease-free interval and may decrease local recurrence. Interstitial laser therapy holds promise for use in the treatment of locally advanced breast tumors and has been suggested by some as a potential modality for the primary therapy of breast cancer. The clinical use of lasers in the treatment of breast cancer is justified. © 1995 Wiley-Liss, inc.
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Lasers and light source technologies have been applied to a wide variety of open and laparoscopic procedures in general surgery and other disciplines. The ability to produce highly precise and controllable effects on tissues, and the potential to facilitate complex dissection make these devices a welcome addition to the armamentarium of the surgeon. Each laser wavelength has a characteristic effect on tissue and it is the combination of the laser tissue interaction and the selection of the appropriate delivery systems and laser parameters that determine the ultimate effects of laser use during surgery. This chapter will review the array of laser technologies available for both open and laparoscopic surgical use and will discuss the relative merits and disadvantages of each.
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