Clinical Research Of Holmium Laser Therapy For Extramammary Paget Disease

Objective: To investigate the safety and efficiency of the holmium laser therapy ofextramammary Paget disease.Patients and Methods：A pre-experiment was performed for parameter setting that3post-circumcision prepuces cases were underwent the treatment of holmium laser. Onecase used holmium laser with1.0J20Hz on prepuce. The second case used holmiumlaser with2.0J20Hz. The third one used holmium laser with3.0J20Hz. The results ofthe3post-circumcision prepuces were compared based on the biopsy and the bestparameter was used in the clinical study.From2002to2012,61patients confirmed as non-subcutaneous tissue invasiveextramammary Paget disease by biopsy were underwent surgery. All patients wererandomly divided into2groups.30patients underwent the treatment of the holmiumlaser.31patients underwent the treatment of traditional operation. All patients’ clinicaldata included preoperative, operative, postoperative management and follow-up wererecorded.Results: The pre-experiment showed that the holmium laser could break theepidermis completely(The parameter settings:2.0J,20Hz). But, the dermis of the3prepuces with once holmium laser therapy could not be completely broken, the depthwas not uniform.According to clinical study, only after the second time of holmium laser therapycould effectively destroy the dermis which was stripped the slough.Compared with the traditional operation group, the holmium laser group had shorteroperative duration and easier opration. There were no significant differences betweenthe2groups from the perspectives of intraoperative and postoperative complications,and the recurrence-free survival and the disease-specific survival. But, the holmiumlaser group was longer than the traditional operation group about bigger and deepernidus.61patients multiple-factor analysis of prognostic parameters for recurrence-free survival confirmed that2of the methods chosen was not prognostic parameter.Conclusions: The holmium laser therapy might prove to be a preferable alternative totraditional operation management of extramammary Paget disease. However, theholmium laser therapy did not demonstrate to be an obvious advantage treatment overtraditional operation in the recurrence-free survival and the disease-specific survival.