Meta-Analysis of Low Temperature Plasma Radiofrequency Ablation and CO2 Laser Surgery on Early Glottic Laryngeal Carcinoma

Abstract

Objective: Meta-analysis is used to analyze the treatment of early glottic laryngeal carcinoma by cryogenic plasma radiofrequency ablation combined with CO₂ laser surgery.

Methods: Retrieval of PubMed, Embase, Medline, VIP, Wanfang, and CNKI databases using a computer. The retrieval period is from the creation of the database until August 31, 2021. References to the included literature were also searched at the same time. According to the inclusion and exclusion criteria, literatures are screened independently, relevant data were extracted, and meta-analysis was conducted.

Results: Recurrence rates are reported in seven literatures. In interstudy heterogeneity test: P = 0.624, I ² = 0%, fixed effect model analysis shows that there is no significant difference in recurrence rate between low temperature plasma radiofrequency ablation and CO₂ laser ablation (OR = 0.80, 95% CI (0.35, 1.29), P = 0.371). Intraoperative blood loss is reported in 5 literatures, and heterogeneity test of each study is as follows: P = 0.03, I ² = 67%. Low temperature plasma radiofrequency ablation results in more intraoperative blood loss than CO₂ laser ablation (SMD = -0.71, 95% CI (0.08, 0.82), P = 0.01). There are five reports on postoperative pain in two treatments: P = 0.04, I ² = 64%. There is no significant difference in postoperative pain between low temperature plasma radiofrequency ablation and CO₂ laser ablation (SMD = -0.21, 95% CI (-0.44, 0.10), P = 0.134). Operative time is reported in nine articles: P < 0.01, I ² = 95%. The operative time of low temperature plasma radiofrequency ablation is significantly shorter than CO₂ laser ablation (SMD = -2.38, 95% CI (-3.91, -1.62), P < 0.01). There are two reports on postoperative mucosal recovery: P = 0.328, I ² = 2%. Low temperature plasma radiofrequency ablation was significantly better than CO₂ laser ablation in postoperative mucosal recovery (OR = 5.49, 95% CI (2.36, 10.18), P < 0.01).

Conclusion: Low temperature plasma radiofrequency ablation is superior to CO₂ laser surgery in the treatment of early glottic laryngeal carcinoma in terms of operative time and postoperative mucosal recovery. Low-temperature plasma radiofrequency ablation, on the other hand, results in higher intraoperative blood loss, with no discernible difference in recurrence rate or postoperative pain severity between the two treatments.