Dziegielewski Peter T, Boyce Brian J, Old Matthew, Teknos Theodoros N, Agrawal Amit, Patwa Hafiz, Ozer Enver
Department of Otolaryngology, University of Florida, Gainesville, Florida.
University of Florida Health Cancer Center, University of Florida, Gainesville, Florida.
Head Neck. 2017 Nov;39(11):2224-2231. doi: 10.1002/hed.24887. Epub 2017 Aug 7.
The purpose of this study is to determine the incidence and risk factors for bilateral tonsillar cancers treated with transoral robotic surgery (TORS) and to determine the morbidity of the procedure.
Patients undergoing TORS for known tonsillar cancer were retrospectively reviewed. Perioperative variables and surgical outcomes were analyzed to determine predictive factors for bilateral disease and morbidity rates.
Seventy-nine consecutive patients with tonsillar cancers underwent primary TORS radical tonsillectomy. Thirty of these patients also underwent contralateral tonsillectomy. Three patients (10%) were found to have contralateral tonsillar cancers on final pathology. These were not identified on preoperative positron emission tomography (PET)-CT or clinical examination. There were no differences in complications, gastrostomy tube (G-tube) rates, or length of stay (P > .05). Blood loss was 11.5 cc more in the contralateral tonsillectomy group (P = .001).
All patients undergoing primary TORS for tonsillar cancers should also undergo contralateral tonsillectomy to optimize oncologic outcomes with no increase in morbidity.
本研究的目的是确定经口机器人手术（TORS）治疗双侧扁桃体癌的发病率和危险因素，并确定该手术的发病率。
对已知扁桃体癌接受TORS治疗的患者进行回顾性研究。分析围手术期变量和手术结果，以确定双侧疾病的预测因素和发病率。
79例连续的扁桃体癌患者接受了初次TORS根治性扁桃体切除术。其中30例患者还接受了对侧扁桃体切除术。最终病理检查发现3例患者（10%）存在对侧扁桃体癌。术前正电子发射断层扫描（PET）-CT或临床检查未发现这些病例。并发症、胃造瘘管（G管）使用率或住院时间方面无差异（P>.05）。对侧扁桃体切除术组失血多11.5 cc（P=.001）。
所有因扁桃体癌接受初次TORS治疗的患者也应接受对侧扁桃体切除术，以优化肿瘤学结局，且不增加发病率。
