Daily Cosmetic Research Analysis
A randomized trial showed that using a central venous catheter (CVC) as a drain in transoral vestibular endoscopic thyroidectomy improves scar scores and patient satisfaction without increasing complications. An umbrella review of photodynamic therapy (PDT) across cancers highlights survival benefits in unresectable cholangiocarcinoma when combined with stenting or chemotherapy and better cosmetic outcomes for select skin cancers, though overall evidence remains weak. A prospective single-blind
Summary
A randomized trial showed that using a central venous catheter (CVC) as a drain in transoral vestibular endoscopic thyroidectomy improves scar scores and patient satisfaction without increasing complications. An umbrella review of photodynamic therapy (PDT) across cancers highlights survival benefits in unresectable cholangiocarcinoma when combined with stenting or chemotherapy and better cosmetic outcomes for select skin cancers, though overall evidence remains weak. A prospective single-blind study suggests focused ultrasound outperforms radiofrequency in early facial rejuvenation outcomes with similar safety.
Research Themes
- Aesthetic outcomes optimization in surgical and procedural dermatology
- Comparative effectiveness of non-invasive facial rejuvenation devices
- Oncologic photodynamic therapy with emphasis on cosmesis and survival
Selected Articles
1. Enhanced cosmetic outcomes with central venous catheter drainage in transoral vestibular endoscopic thyroidectomy: a prospective randomized-controlled trial.
In a single-center randomized controlled trial of 104 patients undergoing transoral vestibular endoscopic thyroidectomy, using a central venous catheter as a drain led to significantly better scar scores and higher patient satisfaction compared with a conventional drain. Drainage volumes and complication rates were similar, indicating improved cosmesis without compromising safety.
Impact: This RCT provides pragmatic evidence that a simple change in drain type can measurably improve postoperative cosmesis in a scar-sensitive procedure. It offers an immediately actionable technique with minimal cost or workflow impact.
Clinical Implications: Consider CVC-based drainage to optimize scar outcomes after transoral thyroidectomy, with counseling that safety and drainage efficacy are maintained. Incorporate objective scar scoring into routine follow-up.
Key Findings
- Randomized 104 patients to CVC drain vs conventional drain with identical operative protocols and 48-hour removal.
- No differences in drainage volumes at 24 h (3.69 vs 3.63 mL) and 48 h (2.46 vs 2.31 mL) or complication rates between groups.
- SCAR and VAS scar scores were significantly lower in the CVC group (p<0.01), and patient satisfaction scores were higher.
- Follow-up at 1, 3, and 6 months confirmed durable aesthetic improvements.
Methodological Strengths
- Randomized controlled design with standardized operative protocols
- Use of validated scar assessment scales (SCAR, VAS, PSS) and predefined follow-up time points
Limitations
- Single-center trial with relatively short follow-up (6 months)
- Blinding and allocation concealment procedures were not detailed
Future Directions: Conduct multicenter, blinded RCTs with longer follow-up and patient-reported outcome measures to validate generalizability and durability. Cost-effectiveness and applicability to other endoscopic head and neck procedures should be explored.
With the rising incidence of thyroid cancer, there is an increasing focus on the cosmetic outcomes of thyroid surgery. This study introduces the use of a central venous catheter (CVC) tube as an innovative approach to enhance the aesthetic outcomes of drainage following transoral vestibular endoscopic thyroidectomy. A total of 104 patients were evenly assigned to either the conventional drainage tube group or the CVC tube group. All procedures were performed by the same experienced surgical team following identical operative protocols. The drainage devices were removed 48 h postoperatively, and all patients were discharged within this timeframe. Follow-up assessments were conducted at 1, 3, and 6 months postoperatively. Scar formation and patient satisfaction were evaluated using the SCAR, VAS, and Patient Scar Satisfaction (PSS) scores. The clinical and surgical characteristics of the two groups did not exhibit significant differences. The average age was 33.56 years in the conventional group compared to 36.83 years in the CVC group. The cervical effusion volume recorded in the CVC group (3.69 mL at 24 h and 2.46 mL at 48 h postoperatively) was similar to that observed in the conventional group (3.63 mL at 24 h and 2.31 mL at 48 h postoperatively), with no statistically significant variance. Furthermore, the rates of complications were comparable between the groups. Notably, the SCAR and VAS scores, which evaluate postoperative scarring, were significantly reduced in the CVC group (p < 0.01), suggesting enhanced cosmetic results. Additionally, patient satisfaction was markedly higher in the CVC group. Our data objectively demonstrate superior postoperative cosmesis and satisfaction following in CVC tube comparison with regular tube.
2. Umbrella review of photodynamic therapy for cancer: efficacy, safety, and clinical applications.
This umbrella review synthesized 18 systematic reviews/meta-analyses on PDT for cancer. It found signals of improved survival for unresectable cholangiocarcinoma when PDT was combined with stenting or chemotherapy and better cosmetic outcomes for certain skin cancers, though clearance and recurrence favored surgery. Overall, evidence quality was limited and heterogeneity substantial.
Impact: By consolidating meta-analytic evidence across cancers, this work clarifies where PDT offers survival or cosmetic advantages and where it may be inferior, guiding clinical decision-making and research priorities.
Clinical Implications: For unresectable cholangiocarcinoma, consider PDT in combination with stenting or chemotherapy. In non-melanoma skin cancers, PDT may be preferred when cosmetic outcomes are paramount, but surgery remains superior for clearance and recurrence control.
Key Findings
- Included 18 publications; AMSTAR2 used for quality, Corrected Covered Area applied to assess overlap, random-effects re-synthesis performed.
- PDT plus biliary stenting improved overall survival versus stenting alone (HR 0.49, 95% CI 0.33-0.73); PDT plus chemotherapy also improved OS (HR 0.36, 95% CI 0.15-0.87).
- In non-melanoma skin cancers (especially BCC), surgery had higher clearance/CR and lower recurrence than PDT, but PDT yielded better cosmetic outcomes.
- Laser-assisted PDT achieved higher complete response in SCC than conventional PDT (RR 2.75; 95% CI 2.19-3.45).
Methodological Strengths
- Registered protocol (PROSPERO CRD42024538243) and use of AMSTAR2 for quality appraisal
- Handled overlap across meta-analyses (Corrected Covered Area) and applied random-effects synthesis
Limitations
- Overall evidence graded as weak with substantial heterogeneity and reliance on non-randomized or older studies
- Outcome definitions and photosensitizer/technique variations limit comparability
Future Directions: Prioritize high-quality randomized trials comparing PDT versus surgery or combined modalities with standardized cosmetic and oncologic outcomes; evaluate newer laser-assisted and targeted PDT approaches.
BACKGROUND: Photodynamic therapy (PDT) can target cancers, while causing little damage to surrounding healthy tissues. OBJECTIVE: To systematically evaluate the efficacy, safety, and clinical applications of PDT across cancer types. METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to April 7, 2024 for systematic reviews and meta-analyses of PDT in patients with cancer. Quality assessment was performed using Assessment of Multiple Systematic Reviews 2, overlapping meta-analyses were handled using Corrected Covered Area, and data re-synthesized using a random-effects model. RESULTS: Eighteen publications met the inclusion criteria. There is weak evidence that PDT combined with biliary stenting improves overall survival (OS) relative to stenting alone (hazard ratio (HR) 0.49, 95% confidence interval (CI) 0.33-0.73), while PDT with chemotherapy improved OS (HR 0.36, 95% CI 0.15-0.87), without increasing adverse events. Weak evidence indicated lower clearance and complete response rates and higher recurrence rates of non-melanoma skin cancers, particularly basal cell carcinoma (BCC), after PDT than following surgery. In squamous cell carcinoma (SCC), complete response rates (relative risk 2.75; 95% CI 2.19-3.45) were higher for laser-assisted than conventional PDT; PDT provided better cosmetic outcomes than other therapies. Single-arm meta-analyses demonstrated some efficacy of PDT for treating cutaneous metastatic SCC, oral SCC, prostate cancer, and bladder cancer. CONCLUSION: PDT shows potential benefits in several cancers, especially for non-melanoma skin cancer and unresectable cholangiocarcinoma. While newer PDT strategies may improve outcomes, more high-quality trials are needed to confirm its role across cancer types. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024538243, identifier CRD42024538243.
3. Efficacy and Safety of Radiofrequency and Focused Ultrasound in Facial Rejuvenation: A Single-Center, Single-Blind, Non-Randomized Prospective Trial.
In a single-center, single-blind prospective trial (n=36), both radiofrequency and focused ultrasound improved wrinkle scales over time, with focused ultrasound showing superior early efficacy in the mid- and lower face at 1 month. Safety profiles were comparable and patient satisfaction was high for both modalities.
Impact: Provides head-to-head comparative data for two widely used non-invasive rejuvenation technologies, informing device selection and patient counseling.
Clinical Implications: For patients seeking non-invasive facial tightening, focused ultrasound may yield earlier improvements in mid/lower face laxity, while both RF and FU are safe options. Selection can be tailored to anatomical targets and patient preferences.
Key Findings
- Prospective, single-blind comparison of RF (n=21) versus FU (n=15) with assessments at baseline, 1 month, and 3 months.
- FU outperformed RF in mid-face (Z=2.915, p=0.004) and lower face (Z=2.142, p=0.046) at 1 month.
- Both modalities significantly reduced FLR and MFWS scores within groups; no severe adverse events occurred and satisfaction was high.
Methodological Strengths
- Prospective design with blinded dermatologist assessments using multiple validated wrinkle scales
- Prospective trial registration (ChiCTR2500097849)
Limitations
- Non-randomized allocation and small sample size
- Single treatment session and short follow-up (3 months) may underestimate durability
Future Directions: Conduct randomized, adequately powered trials comparing device parameters and multi-session protocols with longer follow-up and objective biomechanical skin measures.
BACKGROUND: Although both radiofrequency (RF) and focused ultrasound (FU) are commonly used non-invasive skin-tightening methods, comparative studies between the two methods are lacking. OBJECTIVE: To study and compare the efficacy and safety of RF and FU in facial rejuvenation. METHODS: We recruited 36 patients to receive a single treatment: the RF group (n = 21) and the FU group (n = 15). Every participant was evaluated on baseline (T0), 1-month follow-up (T1) and 3-month follow-up (T3). Three blinded dermatologists used the FLR scale, Modified Fitzpatrick Wrinkle Scale (MFWS), and Allergan Skin Roughness Scale to assess facial wrinkles. Safety profiles were recorded, and subjects completed questionnaires to provide subjective evaluations. RESULTS: Intergroup comparison indicated that the ultrasound group showed superior efficacy over the RF group in the mid-face (Z = 2.915, p = 0.004) and lower face (Z = 2.142, p = 0.046) on T1. Intragroup comparison observed a statistically significant reduction in FLR and MFWS scores with both treatments. Subjective satisfaction aligned with objective results, and no severe adverse reactions were observed. CONCLUSION: Both RF and FU are effective in facial rejuvenation, though their efficacy differs. They are comparably safe and yield high patient satisfaction. TRIAL REGISTRATION: ChiCTR number: ChiCTR2500097849.