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耳后除皱术式机器人辅助颈部清扫术治疗头颈癌的功能及美容效果

Functional and cosmetic outcomes of robot-assisted neck dissection by a postauricular facelift approach for head and neck cancer.

作者信息

Ji Yong Bae, Song Chang Myeon, Bang Hyang Sook, Park Hae Jin, Lee Ji Young, Tae Kyung

机构信息

Department of Otolaryngology - Head and Neck Surgery, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.

Department of Radiation Oncology, College of Medicine, Hanyang University, Seoul 04763, Republic of Korea.

出版信息

Oral Oncol. 2017 Jul;70:51-57. doi: 10.1016/j.oraloncology.2017.05.014. Epub 2017 May 31.

Abstract

OBJECTIVES

The purpose of this study was to compare the functional and cosmetic outcomes of robot-assisted neck dissection with those of conventional neck dissection.

MATERIALS AND METHODS

We prospectively analyzed 113 patients with head and neck cancer who underwent unilateral neck dissection by a robot-assisted postauricular facelift approach (38 patients) or conventional trans-cervical approach (75 patients). Postoperative functional outcomes such as edema, sensory loss, pain, and fibrosis in the neck, and limitations of neck and shoulder motion, and cosmetic satisfaction scored by questionnaire were evaluated serially up to 1year postoperatively, and compared between the two groups.

RESULTS

There were differences at baseline clinicopathologic characteristics including age, T classification and stage between the two groups. The mean score of neck edema was lower in the robotic group than that of the conventional group at 1day and 3days postoperatively, and sensory loss was also lower in the robotic group at 1day, 3days and 1week postoperatively (P<0.05). The postoperative cosmetic satisfaction were significantly higher in the robotic group than the conventional group at 1month, 3, 6, and 12months postoperatively. Transient marginal nerve palsy was higher in the robotic group than the conventional group (P=0.043).

CONCLUSION

Postoperative neck edema and sensory loss were lower in the robotic group in the early postoperative period although its clinical significance is not clear. Cosmetic satisfaction was superior in the robotic group.

摘要

目的

本研究旨在比较机器人辅助颈部清扫术与传统颈部清扫术的功能和美容效果。

材料与方法

我们前瞻性分析了113例头颈部癌患者,这些患者通过机器人辅助耳后除皱术式(38例)或传统经颈术式(75例)接受了单侧颈部清扫术。术后对颈部水肿、感觉丧失、疼痛、纤维化等功能结局,以及颈部和肩部活动受限情况进行评估,并通过问卷调查对美容满意度进行评估,直至术后1年,并对两组进行比较。

结果

两组在包括年龄、T分级和分期等基线临床病理特征方面存在差异。机器人组术后1天和3天时颈部水肿的平均评分低于传统组,术后1天、3天和1周时机器人组的感觉丧失情况也较轻(P<0.05)。术后1个月、3个月、6个月和12个月时,机器人组的美容满意度显著高于传统组。机器人组的暂时性边缘神经麻痹发生率高于传统组(P=0.043)。

结论

机器人组术后早期颈部水肿和感觉丧失较轻,但其临床意义尚不清楚。机器人组的美容满意度更高。

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