Krishnan Giri, Krishnan Suren
Department of Otolaryngology, Head and Neck Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia.
ORL J Otorhinolaryngol Relat Spec. 2017;79(4):191-201. doi: 10.1159/000464138. Epub 2017 Jun 14.
Transoral robotic surgery total laryngectomy (TORS-TL) is a minimally invasive endoscopic surgical approach which can theoretically minimise the morbidity of large external incisions and limit dissection of tissue planes so as to reduce the risk of pharyngocutaneous fistulae related to poor tissue healing secondary to radiation soft tissue injury or malnutrition. The purpose of this paper was to report our experience with this uncommon surgical approach.
A retrospective chart review was conducted at a single institution to evaluate the functional and survival outcomes of a series of patients who underwent TORS-TL.
TORS-TL was performed on 5 patients. Two patients had total laryngectomy for recurrent aspiration secondary to neurological disorders, 1 patient had an adenoid cystic carcinoma of the subglottis, 1 patient had a low-grade subglottic chondrosarcoma, and 1 patient had a T2 local recurrence of glottic squamous cell carcinoma following treatment with primary chemoradiotherapy.
TORS-TL is a feasible and safe treatment option with possible advantages for carefully selected patients in experienced hands.
经口机器人手术全喉切除术(TORS-TL)是一种微创内镜手术方法,理论上可以将大型外部切口的发病率降至最低,并限制组织层面的解剖,从而降低因放射软组织损伤或营养不良导致组织愈合不良相关的咽皮肤瘘风险。本文旨在报告我们对这种不常见手术方法的经验。
在单一机构进行回顾性病历审查,以评估一系列接受TORS-TL患者的功能和生存结果。
对5例患者进行了TORS-TL手术。2例患者因神经功能障碍继发反复误吸而接受全喉切除术,1例患者患有声门下腺样囊性癌,1例患者患有低度声门下软骨肉瘤,1例患者在接受原发性放化疗后出现T2期声门鳞状细胞癌局部复发。
对于经验丰富的医生精心挑选的患者,TORS-TL是一种可行且安全的治疗选择,可能具有优势。