Kawasaki Yohei, Omori Yasufumi, Saito Hidekazu, Suzuki Shinsuke, Matsuhashi Tamotsu, Yamada Takechiyo
Department of Otorhinolaryngology and Head-and-Neck Surgery, Akita University, Graduate School of Medicine, Akita, Japan.
Department of Molecular and Tumour Pathology, Akita University, Graduate School of Medicine, Akita, Japan.
Wideochir Inne Tech Maloinwazyjne. 2018 Sep;13(3):394-400. doi: 10.5114/wiitm.2018.76956. Epub 2018 Jul 5.
Robotic surgery is used in Europe and the US for oropharyngeal/hypopharyngeal cancers. Although robots can successfully perform procedures that are too delicate for surgeons and quickly learn accurate techniques, robotic surgery is not still authorized for the craniocervical region in Japan. In Japan, endoscopic laryngopharyngeal surgery (ELPS) is widely performed. Because oropharyngeal/hypopharyngeal cancer can be resected at an early stage, we have contributed to an improvement in the survival rate.
To analyze clinical outcomes and risk factors of postoperative cervical lymph node metastases after ELPS.
Fifty-two patients with 71 superficial oropharyngeal/hypopharyngeal cancers were included. A Sato-type arcuation laryngoscope was inserted, and oropharyngeal and hypopharyngeal fields were secured. We have recently been performing head and neck surgery using only a flexible endoscope because gastroscopy and arcuation-type forceps interfere with each other.
The 5-year survival rate was 95.2%. The risk factors of lymph node metastases were examined. The depth of the tumor significantly affected lymph node metastases.
With a favorable 5-year survival rate and low functional impairment, ELPS is an extremely effective form of treatment. It can provide a clear field of view in the hypopharynx and has a low cost; hence, it should be further developed as a treatment method.
机器人手术在欧美被用于治疗口咽/下咽癌。尽管机器人能够成功完成对外科医生来说过于精细的手术，并能快速掌握精确的技术，但在日本，机器人手术仍未被批准用于颅颈区域。在日本，内镜下咽手术（ELPS）被广泛开展。由于口咽/下咽癌能够在早期被切除，我们对生存率的提高做出了贡献。
分析内镜下咽手术后颈部淋巴结转移的临床结果及危险因素。
纳入52例患有71处浅表口咽/下咽癌的患者。插入佐藤型弧形喉镜，确保口咽和下咽视野。由于胃镜检查和弧形钳相互干扰，我们最近仅使用柔性内窥镜进行头颈手术。
5年生存率为95.2%。对淋巴结转移的危险因素进行了检查。肿瘤深度对淋巴结转移有显著影响。
内镜下咽手术具有良好的5年生存率和较低的功能损害，是一种极其有效的治疗方式。它能够提供清晰的下咽视野且成本较低；因此，应作为一种治疗方法进一步发展。
