This study was undertaken to better understand the effectiveness of CO2 laser surgery regarding oral tumours in the dog, comparing it to traditional surgery quality and time, considering also a follow up of 12 months.
Material and methods
CO2 laser emits light beam at 10600 nanometers (far infrared). Main characteristics of CO2 laser are high precision (0.4mm spot diameter), predictable cutting power due to control of beam intensity (thermal damage only 0.1mm of tissue layer), cauterization (vessels <0.6mm) and sealing nerves and lymphatic vessels. A group of 16 dogs of different breeds has been selected. Of this group 9 were males and 7 females from 6 months to 14 years old, mean 8.6 years (+/-3.3). All dogs affected by one oral tumour of 7 types: 5 epulides, 3 melanomas, 4 squamous cell carcinomas, 1 fibrosarcoma, 1 fibroma, 1 adamantinoma and 1 lymphoma. Surgery based on CO2 laser in all cases. Cutting power used was up to 15 watts in the continuous mode and from 5 to 8 watts in the super pulse mode. In 4 cases also a traditional ostectomy has been performed. Antibiotics has been used only in major surgeries (5 cases), chemotherapy in 7 cases 2 weeks after surgery and in no case radiotherapy has been performed.
In 12 cases the amount of blood loss was minimal, postoperative pain and discomfort was evident in only 4 cases, no infection has been reported in the 11 cases who used no antibiotics, and in these cases (all gingival and tongue tumours) also surgery time was inferior in relation to traditional surgery. In all cases no tissue reaction (oedema) has been observed after surgery and heeling was relatively rapid (5-9 days). Follow up of 1, 3, 6 and 12 months after surgery showed normality after 12 months in 11 cases, 1 case of local recurrence (within 1 month) and 4 cases of regional metastasis (within 3 months). There was no evidence of distal metastasis in any of the 16 dogs.
CO2 laser improved surgery quality and time mainly due to no or little bleeding. Postoperative course also improved in most cases due to no infection, no tissue reaction and fast heeling. Real metastatic prevention is unclear in major surgeries probably due to major vessel and bone involvement. CO2 laser activity on oral tissues produce smoke, therefore a smoke evacuation device is necessary. CO2 laser articulated delivery device is easy to manipulate externally but is sometimes difficult deep in oral cavity.