Meta Analysis Of Effect Comparison Of Low Temperature Plasma And CO₂ Laser In The Treatment Of Early Glottic Cancer

Objective:To provide evidence-based medical evidence for the surgical treatment of early glottic laryngeal cancer,a meta-analysis was conducted to compare the efficacy of transoral low-temperature plasma radiofrequency ablation?RFA?and transoral CO₂ laser surgery?CLS?in the treatment of early glottic laryngeal cancer.Methods:Searching clinical research literature of the low temperature plasma radiofrequency ablation through the mouth and CO₂ laser microsurgery treatment early glottis cancer by the Cochrane Library,Embase,Pubmed and Google Scholar,Veb Of Science,Medline,China Cnki,WangFang Med Online,VIP Database Resources Platform,Service System Of Chinese Biomedical Literature,Chinese Science and Technology Journal Full-text Database Of Medical Literature Databases.?Searching period is building database to 31.December,2019.?According to the inclusion and exclusion criteria,the literatures of clinical randomized controlled studies and retrospective case-control studies were screened out.Endnote X7 was used to manage the literature.Clinical randomized controlled studies were selected for quality evaluation according to the Cochrance scale,and clinical retrospective case-control studies were selected for quality evaluation according to the newcastle-ottawa scale?NOS?.And extracted data from the literature on the efficacy of transoral CO₂ laser and low-temperature plasma radiofrequency ablation in the treatment of early glottic laryngeal cancer.Meta analysis of efficacy comparison was performed with RevMan5.3.If the heterogeneity is small,I²<50%,the fixed effect model of the research data is merged.If the heterogeneity is large,when I²>50%,the random effect model is used for merging,and subgroup analysis and sensitivity analysis are performed.In addition,publication bias analysis was carried out for more than 5 studies including a single research index.Results:The total number of cases was 1198,including 605 cases in the low-temperature plasma group and 593 cases in the CO₂ laser treatment group.All the included cases were from China.According to inclusion and exclusion criteria,a total of 14 references were included,8 of which were randomized controlled clinical trials and 6 were cohort studies.The results of meta-analysis show that:In Randomized controlled study,low-temperature plasma surgery was superior to CO₂ laser surgery in Shimmer and operation time 1 month after the operation.There was no significant difference in local recurrence rate,3-year survival rate,1 month after surgery Jitter,1 month after surgery HNR,and 24 hours after surgery pain,.In the cohort study,low-temperature plasma surgery was superior to CO₂laser surgery in terms of operation time,1 month after operation Jitter and 1 month after operation Shimmer.There was no significant difference between the two operations in terms of local recurrence rate,3-year survival rate,complication rate,postoperative 1month HNR,intraoperative blood loss,and postoperative pain 24 hours.Conclusion:?1?In the treatment of early glottic cancer,it was no difference between the Low temperature plasma and CO₂ laser in Local recurrence,Rate 3-year survival rate,Complication rate,Intraoperative blood loss,Postoperative pain degree after 24 hour,1month after surgery HNR.And in the Operation time,1 month after operation Shimmer,Low temperature plasma is better than that of CO₂ laser surgery.?2?Low temperature plasma under endoscope can be used as an option for the treatment of early glottic cancer.