Humanitas University, Via Rita Levi Montalcini, 4, 20090 Pieve Emanuele (MI), Italy; Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy.
Department of Otorhinolaryngology Head and Neck Surgery, IRCCS Humanitas Clinical and Research Center, Via Alessandro Manzoni, 56, 20089 Rozzano (MI), Italy.
Oral Oncol. 2020 Apr;103:104581. doi: 10.1016/j.oraloncology.2020.104581. Epub 2020 Feb 12.
To perform a systematic review of studies evaluating Trans-oral Robotic Surgery (TORS) in the treatment of parapharyngeal space (PPS) tumors.
A comprehensive electronic search was performed in PubMed/MEDLINE, Cochrane Library, and Google Scholar databases for appropriate published studies. The last search was conducted on November 9, 2019.
Twenty-two studies were included for the systematic review which analyzed a total of 113 patients (median age 53.5, IQR 41.5-58.1). The most common PPS tumor treated with TORS was the pleomorphic adenoma (n = 66; 58.4%). All tumors were successfully resected. The median tumor size was 4.8 cm (n = 73; IQR 3.8-5.4). Combined transcervical (TORS-TC) and transparotid (TORS-TP) approaches were used in 13 (11.5%) and 5 (4.4%) patients, respectively. Capsule disruption was noted in 11 cases (14.5%), while tumor fragmentation was observed in 7 patients (10.3%). The median time of hospitalization was 3 days (n = 79; IQR 2-4.1). Oral diet was possible from the day after surgery in the majority of patients (n = 34, 68%). The most common complication was dysphagia (n = 5, 4.5%).
This systematic review confirms the safety and feasibility of TORS in the treatment of PPS lesions. Given the low quality of included studies, further evidence is needed in order to establish clinical guidelines.
对评估经口机器人手术（TORS）治疗咽旁间隙（PPS）肿瘤的研究进行系统评价。
在 PubMed/MEDLINE、Cochrane 图书馆和 Google Scholar 数据库中进行全面的电子检索，以获取合适的已发表研究。最后一次检索时间为 2019 年 11 月 9 日。
共有 22 项研究被纳入系统评价，共分析了 113 例患者（中位数年龄 53.5 岁，IQR 41.5-58.1）。用 TORS 治疗的最常见 PPS 肿瘤是多形性腺瘤（n=66；58.4%）。所有肿瘤均成功切除。肿瘤大小中位数为 4.8cm（n=73；IQR 3.8-5.4）。13 例（11.5%）和 5 例（4.4%）患者分别采用经颈（TORS-TC）和经腮腺（TORS-TP）联合入路。11 例（14.5%）发生包膜破裂，7 例（10.3%）肿瘤碎裂。住院中位数时间为 3 天（n=79；IQR 2-4.1）。大多数患者（n=34，68%）术后第二天即可经口进食。最常见的并发症是吞咽困难（n=5，4.5%）。
本系统评价证实 TORS 治疗 PPS 病变的安全性和可行性。鉴于纳入研究的质量较低，需要进一步的证据来制定临床指南。
