Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
Int J Med Robot. 2014 Mar;10(1):107-12. doi: 10.1002/rcs.1546. Epub 2013 Nov 28.
Transoral laser microsurgery (TLM) is a mature approach to supraglottic cancer, while transoral robotic surgery (TORS) is emerging. The present study compared these approaches.
The first 10 patients (2002-2005) given TLM were compared with the first 10 (2007-2011) given TORS for cT1-3 cN0-cN2c supraglottic cancer.
A feeding tube was used in four TLM and seven TORS patients. Margins were more often positive, but operating times shorter, in TORS. All 10 TORS patients are without evidence of disease, but only six TLM patients remain disease-free after much longer follow-up. TORS was considerably less uncomfortable and fatiguing for the surgeon.
TORS seems as safe and effective as TLM. Shorter TORS operating times are probably attributable to prior experience with TLM. For laryngeal exposure, length of tube placement and margin evaluability, TLM was superior; however, this may change as TORS develops and transoral robotic instruments are optimized.
经口激光微创手术（TLM）是治疗声门上型癌症的一种成熟方法，而经口机器人手术（TORS）则是新兴技术。本研究对这两种方法进行了比较。
将 2002-2005 年间接受 TLM 的前 10 例患者（共 20 例）与 2007-2011 年间接受 TORS 的前 10 例患者（共 20 例）进行比较，两组患者均为 cT1-3、cN0-cN2c 声门上型癌症。
4 例 TLM 患者和 7 例 TORS 患者使用了饲管。TORS 组的切缘阳性率更高，但手术时间更短。所有 10 例 TORS 患者均无疾病证据，但 TLM 组仅 6 例患者在更长的随访时间后仍无疾病。TORS 对术者来说明显不那么不适和疲劳。
TORS 似乎与 TLM 一样安全有效。TORS 较短的手术时间可能归因于 TLM 的前期经验。在喉暴露、管放置长度和切缘评估方面，TLM 更优；然而，随着 TORS 的发展和经口机器人器械的优化，这种情况可能会改变。
