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Transoral laser surgery for laryngeal carcinoma: has Steiner achieved a genuine paradigm shift in oncological surgery?
Harris, A T; Tanyi, A; Hart, R D; Trites, J; Rigby, M H; Lancaster, J; Nicolaides, A; Taylor, S M.
Afiliación
  • Harris AT; Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of medicine, Dalhousie University , Halifax, Nova Scotia , Canada.
  • Tanyi A; Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of medicine, Dalhousie University , Halifax, Nova Scotia , Canada.
  • Hart RD; Collegium Helveticum, ETH/University of Zurich , Zurich , Switzerland.
  • Trites J; Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of medicine, Dalhousie University , Halifax, Nova Scotia , Canada.
  • Rigby MH; Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of medicine, Dalhousie University , Halifax, Nova Scotia , Canada.
  • Lancaster J; Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Faculty of medicine, Dalhousie University , Halifax, Nova Scotia , Canada.
  • Nicolaides A; Department of Head and Neck Surgery, University Hospital Aintree , Liverpool, Merseyside , UK.
  • Taylor SM; Department of Head and Neck Surgery, York Teaching Hospital NHS Trust , UK.
Ann R Coll Surg Engl ; 100(1): 2-5, 2018 Jan.
Article en En | MEDLINE | ID: mdl-29046085
Transoral laser microsurgery applies to the piecemeal removal of malignant tumours of the upper aerodigestive tract using the CO2 laser under the operating microscope. This method of surgery is being increasingly popularised as a single modality treatment of choice in early laryngeal cancers (T1 and T2) and occasionally in the more advanced forms of the disease (T3 and T4), predominantly within the supraglottis. Thomas Kuhn, the American physicist turned philosopher and historian of science, coined the phrase 'paradigm shift' in his groundbreaking book The Structure of Scientific Revolutions. He argued that the arrival of the new and often incompatible idea forms the core of a new paradigm, the birth of an entirely new way of thinking. This article discusses whether Steiner and colleagues truly brought about a paradigm shift in oncological surgery. By rejecting the principle of en block resection and by replacing it with the belief that not only is it oncologically safe to cut through the substance of the tumour but in doing so one can actually achieve better results, Steiner was able to truly revolutionise the management of laryngeal cancer. Even though within this article the repercussions of his insight are limited to the upper aerodigestive tract oncological surgery, his willingness to question other peoples' dogma makes his contribution truly a genuine paradigm shift.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Laríngeas / Terapia por Láser Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Ann R Coll Surg Engl Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Laríngeas / Terapia por Láser Tipo de estudio: Guideline Límite: Humans Idioma: En Revista: Ann R Coll Surg Engl Año: 2018 Tipo del documento: Article País de afiliación: Canadá Pais de publicación: Reino Unido