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机器人辅助经改良面颈部提升或耳后入路颏下区颈清扫术治疗口腔早期 cN0 鳞癌:与传统技术的对比研究。

Robot-assisted Supraomohyoid neck dissection via a modified face-lift or retroauricular approach in early-stage cN0 squamous cell carcinoma of the oral cavity: a comparative study with conventional technique.

机构信息

Department of Otolaryngology Head and Neck Surgery, Kosin University College of Medicine, Busan, South Korea.

出版信息

Ann Surg Oncol. 2012 Nov;19(12):3871-8. doi: 10.1245/s10434-012-2423-2. Epub 2012 May 30.

Abstract

BACKGROUND

Supraomohyoid neck dissection (SOND) in clinical N0 (cN0) neck of oral cavity squamous cell carcinoma (SCC) is performed by many head and neck surgeons showing improved regional control and disease-specific survival. However, disfiguring neck scars have been accepted to be unavoidable. In this study, we sought to introduce and evaluate the feasibility of our surgical technique to hide the external scar of neck dissection using the robotic system via a modified face-lift or retroauricular approach.

METHODS

Twenty-six patients with cN0 oral cavity SCC were divided into two groups of robot-assisted neck dissection and conventional neck dissection via external cervical incision. The operation time, amount and duration of drainage, length of hospital stay, complications, number of retrieved lymph nodes, and satisfaction scores were compared.

RESULTS

Mean operation time was longer in the robot-assisted group (157 ± 22 min) than the conventional group (78 ± 16 min) (P < 0.001). However, the amount and duration of drainage, hospital stay, retrieved lymph nodes, and complications were comparable. Because the postoperative scar was hidden by the auricle and hair, the satisfaction score was significantly higher in the robot-assisted group (P < 0.001).

CONCLUSIONS

Robot-assisted SOND via a modified face-lift or retroauricular approach in cN0 oral cavity SCC was feasible compared to conventional technique and showed a clear cosmetic benefit. Longer operation time remains the drawback of this procedure. However, it could be considered for patients who require SOND and prefer to avoid external neck scar.

摘要

背景

许多头颈部外科医生对临床 N0(cN0)口腔鳞状细胞癌(SCC)颈部施行 supraomohyoid 颈清扫术(SOND),显示出改善的区域性控制和疾病特异性生存率。然而,毁容性的颈部疤痕被认为是不可避免的。在这项研究中,我们试图介绍并评估我们的手术技术的可行性,通过改良的面部提升或耳后入路使用机器人系统隐藏颈清扫术的外部疤痕。

方法

26 例 cN0 口腔 SCC 患者分为机器人辅助颈清扫术组和传统颈外切口颈清扫术组。比较手术时间、引流量和时间、住院时间、并发症、淋巴结清扫数量和满意度评分。

结果

机器人辅助组的平均手术时间(157±22 分钟)长于传统组(78±16 分钟)(P<0.001)。然而,引流量和时间、住院时间、淋巴结清扫数量和并发症相当。由于术后疤痕被耳和头发隐藏,机器人辅助组的满意度评分明显更高(P<0.001)。

结论

与传统技术相比,机器人辅助改良面部提升或耳后入路 SOND 在 cN0 口腔 SCC 中是可行的,并且具有明显的美容优势。较长的手术时间仍然是该手术的缺点。然而,对于需要 SOND 且希望避免颈部外部疤痕的患者,可以考虑使用该方法。

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