Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (6): 63-71.doi: 10.6040/j.issn.1673-3770.0.2019.570

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The therapeutic effects of low temperature plasma radiofrequency ablation and CO2 laser surgery on early glottic carcinoma: a Meta-analysis

TAN Fengwu, DENG Yaping, LI Kehua   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, the Affiliated Zhuzhou Hospital of Xiangya School of Medicine CSU, Zhuzhou 412000, Hunan, China
  • Published:2021-01-11

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Abstract: Objective To evaluate the clinical effects of low temperature plasma radiofrequency ablation(LTP-RFA)using a suspension laryngoscope and CO2 laser surgery on early glottic carcinoma by a meta-analysis. Methods Related literature was retrieved from electronic databases, including PubMed, EMbase, Medline, VIP, Wanfang, and CNKI, from inception to June 1st, 2019. At the same time, the reference lists of the enrolled articles were retrieved manually. Literature comparing the therapeutic effects of LTP-RFA using a suspension laryngoscope and CO2 laser surgery on early glottic carcinoma was retrieved according to the inclusion and exclusion criteria. Literature screening, data extraction, and literature evaluation were carried out by two authors independently. Revman 5.3 software was adopted for meta-analysis. Results A total of 10 studies involving 1 055 patients were enrolled. Meta-analysis results suggested that, compared with CO2 laser surgery, LTP-RFA significantly reduced the operative time ［SMD =-2.97, 95%CI(-4.05, -1.90), P<0.00 001］, shortened the postoperative mucosal recovery time ［OR=5.53, 95%CI(2.84, 10.78), P<0.00 001］and increased intraoperative blood loss ［SMD=-0.73, 95%CI(0.09, 0.71), P=0.01］. In addition, there were no statistically significant differences in recurrence rate ［OR=0.79, 95%CI(0.46, 1.36), P=0.39］, degree of postoperative pain ［SMD=-0.17, 95%CI(-0.43, 0.08), P=0.18］, and postoperative voice quality ［SMD=-0.21, 95%CI(-1.13, 0.71), P=0.65］ between the two methods. However, sensitivity analysis results revealed that this conclusion may not be robust. No obvious publication bias was detected in the funnel plot regarding the operative time and recurrence rate. Conclusion LTP-RFA has a superior effect over CO2 laser surgery in treating early glottic carcinoma in terms of operative time and postoperative mucosal recovery, but LTP-RFA has greater intraoperative blood. There are no statistically significant differences in recurrence rate, postoperative pain degree, and postoperative voice quality between these two approaches.

Key words: Plasma radiofrequency ablation, CO2 laser, Early glottic carcinoma, Meta-analysis, Therapy

CLC Number: 

  • R765.21
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