Kayhan Fatma Tulin, Yigider Ayse Pelin, Koc Arzu Karaman, Kaya Kamil Hakan, Erdim Ibrahim
Otorhinolaryngology and Head and Neck Surgery Clinic, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
Otorhinolaryngology and Head and Neck Surgery Clinic, Gaziosmanpasa University Medical Faculty, Tokat, Turkey.
Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3457-3463. doi: 10.1007/s00405-017-4646-0. Epub 2017 Jun 17.
The feasibility and effectiveness of transoral robotic surgery (TORS) in children with tongue base masses (TBMs) were evaluated. Eight pediatric patients who were treated with TORS for TBMs between January 2010 and January 2016 at a tertiary hospital included in the study. All pathologies were congenital lesions: four were lingual thyroglossal ductus cysts (LTGDCs), one was a minor salivary gland tumor, one was a vallecular cyst, one was a bronchogenic cyst, and one was an ectopic thyroid tissue. TORS was performed successfully in all cases. The mean robotic set-up and exposure time was 13.0 ± 2.1 min (range 10-16 min) and the mean robotic surgery time was 8.8 ± 6.9 min (range 4-25 min). Estimated blood loss was lower than 5 ml for one patient and lower than 50 ml for another one. The remaining patients' estimated blood loss was lower than 10 ml. No patient required tracheostomy intra- or post-operatively. Only one minor complication occurred on day 10 after surgery (minor bleeding), which was resolved without intervention. No major complications or recurrence were observed. Better visualization and small, flexible arms allow surgeons to treat TBM faster and easily using TORS. This leads to decreased morbidity compared to open and transoral endoscopic/microscopic surgical methods. In the future, we believe that TORS may become the gold standard method for the treatment of pediatric TBM with continued development of robotic technology.
评估了经口机器人手术(TORS)治疗儿童舌根肿物(TBM)的可行性和有效性。本研究纳入了一家三级医院在2010年1月至2016年1月期间接受TORS治疗TBM的8例儿科患者。所有病变均为先天性病变:4例为舌甲状腺舌管囊肿(LTGDC),1例为小唾液腺肿瘤,1例为会厌囊肿,1例为支气管源性囊肿,1例为异位甲状腺组织。所有病例TORS均成功实施。机器人安装和暴露的平均时间为13.0±2.1分钟(范围10 - 16分钟),机器人手术的平均时间为8.8±6.9分钟(范围4 - 25分钟)。1例患者估计失血量低于5ml,另1例低于50ml。其余患者估计失血量低于10ml。没有患者在术中或术后需要气管切开术。仅在术后第10天发生1例轻微并发症(轻微出血),未干预即自行缓解。未观察到重大并发症或复发情况。更好的视野和小巧灵活的机械臂使外科医生能够使用TORS更快、更轻松地治疗TBM。与开放手术和经口内镜/显微手术方法相比,这导致发病率降低。未来,我们相信随着机器人技术的不断发展,TORS可能会成为治疗儿童TBM的金标准方法。