(0802) Blue Laser Versus Cold Technique in Resection of Recurrent Respiratory Papillomatosis. Which Is Better?

Introduction: There are several surgical techniques including cold and hot techniques (CO2, Diode, KTP, PDL, BLUE lasers) for recurrent respiratory papillomatosis treatment. Until now, there is no consensus to determine which technique is better in terms of reducing the recurrence. The comparison between techniques will allow an improvement in therapeutic decisions. In this study, we compared recurrence of illness after surgical procedure between cold technique and blue laser technique.

Methods: An observational, retrospective and comparative study was performed including patients of our Institute diagnosed with laryngeal papillomatosis undergoing surgical treatment (cold technique or blue laser). We excluded those with less than 6 months of postsurgical follow-up, use of any adjuvant medical therapy or residual lesions left after surgical procedure. Fisher's exact test, Mann-Whitney U test, and a Cox were performed for statistical analysis.

Results: A total of 247 surgical events were recorded; 216 (87%) were performed with cold technique and 31 (13%) with blue laser. Recurrence of papillomatous lesions during clinical follow-up was lower in those with resection of lesions by blue laser vs cold technique (61% vs 84%, p = 0.025). When comparing the time of recurrence, it was shorter in the cold technique group with no significant difference (median 98 vs 111 days, p = 0.8). Cox regression analysis was performed based on surgical technique (HR 1-06, IC 95% 0.65-1.74), age of the procedure (HR 0.99, IC 95% 0.99-1) and gender (for male HR 1.29, IC 95% 0.97-1.72), with recurrence as the outcome. It was not possible to establish any effect on recurrence in these variables.

Conclusions: In this study, we demonstrated that patients presented a higher rate of recurrence of lesions using cold technique compared with blue laser technique. In those patients who presented recurrence, the time elapsed after the surgical procedure did not differ significantly between the two techniques. Prospective studies comparing different techniques are still needed to establish solid evidence to decide the appropriate surgical technique.