Department of Head and Neck Surgery, University Hospital of Nîmes, Sud de France; University of Montpellier, Sud de France.
Laryngoscope. 2013 Oct;123(10):2485-90. doi: 10.1002/lary.23994. Epub 2013 Aug 5.
OBJECTIVES/HYPOTHESIS: To determine the feasibility and the preliminary oncological results of transoral robotic surgery (TORS) for the treatment of early stage laryngeal tumors.
Retrospective single center study.
We reviewed the medical records of 23 patients who underwent TORS for the treatment of T1 or T2 laryngeal squamous cell carcinoma between August 2009 and March 2012.
Laryngeal tumors were involving the glottis (13 cases) and the supraglottis (10 cases). They were classified T1 N0 in 16 cases, T2 N0 in four cases, and T2 N+ in three cases. The median TORS operative time was 60 minutes (ranging from 30 to 118 minutes). The median hospitalization time was 7.5 days. Histopathological examination of the resected tumors confirmed 14 cases in which the margins were clear, four cases in which the surgical margins were close (less than 1 mm), one case in which the margins were microscopically positive, and in four cases margins status were not able to be recorded. A tracheostomy was carried out for three patients, and 11 patients got a nasogastric feeding tube postoperatively. The local recurrence rate was 8.7% (2/ 23 cases), and in both cases the recurrence occurred in the anterior commissure area only. The overall larynx preservation rate was 95,7% (22/ 23 cases).
In this preliminary study, we demonstrated that laryngeal TORS is feasible and may result in oncological results comparable with other treatment strategies, including laser CO2 surgery. This innovative approach needs to be evaluated through randomized multi-institutional trial.
目的/假设：确定经口机器人手术（TORS）治疗早期喉肿瘤的可行性和初步肿瘤学结果。
回顾性单中心研究。
我们回顾了 2009 年 8 月至 2012 年 3 月期间，23 例接受 TORS 治疗 T1 或 T2 喉鳞状细胞癌的患者的病历。
喉肿瘤累及声门（13 例）和会厌（10 例）。其中 16 例为 T1N0，4 例为 T2N0，3 例为 T2N+。TORS 手术的中位时间为 60 分钟（30-118 分钟）。中位住院时间为 7.5 天。切除肿瘤的组织病理学检查证实 14 例切缘清晰，4 例切缘接近（<1mm），1 例切缘镜下阳性，4 例切缘状态无法记录。3 例患者行气管切开术，11 例患者术后行鼻饲管。局部复发率为 8.7%（2/23 例），且均仅在前联合区复发。喉保留率为 95.7%（22/23 例）。
在这项初步研究中，我们表明，喉 TORS 是可行的，并且可能与其他治疗策略（包括 CO2 激光手术）产生的肿瘤学结果相当。这种创新方法需要通过随机多中心试验进行评估。
4 级。
