Department of Odontostomatology University of Barcelona, School of Dentistry Feixa Llarga, s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain
Med Oral Patol Oral Cir Bucal. 2020 Sep 1;25(5):e599-e607. doi: 10.4317/medoral.23632.
TORS has become one of the latest surgical alternatives in the treatment of oropharynx squamous cell carcinomas (OPSCC) and has become increasingly accepted by surgeons as a treatment option. Surgical robots were designed for various purposes, such as allowing remote telesurgery, and eliminating human factors like trembling. The study aimed to compare systematic review of the available literature in order to evaluate the safety and efficacy of Transoral Robotic Surgery (TORS) compared with open surgery.
We performed a systematic review of the available literature in order to evaluate the safety and effectiveness of TORS compared with open surgery. We compared TORS and open surgery based on 16 outcomes divided in to 3 groups: intra-operative complications, post-operative complications, and functional and oncologic outcomes. An electronic search of observational studies was carried out using the following databases: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Oral Health Group Trials Register, and Scielo. Data analysis was carried out in accordance to Preferred Reporting Items for Systematic Reviews and Metanalysis (PRISMA) and the quality of the studies were evaluated using the Newcastle-Ottawa Scale. No language restrictions were imposed.
From the 4 studies identified (Newcastle-Ottawa Scale mean score 6.5), 371 patients were revised (186 patients were treated with TORS and 185 with conventional surgery). Overall, TORS, when compared with open surgery, appears to have better functional results (less hospital time, decannulation) and fewer intraoperative and post-operative complications. There is no significant difference when assessing the oncological outcomes (positive margins, survival rate) when comparing both techniques.
TORS has an overall better functional outcome, and less intraoperative and postoperative complications with no difference in positive margins and survival rate when compared with conventional therapy.
经口机器人手术（TORS）已成为治疗口咽鳞状细胞癌（OPSCC）的最新手术选择之一，越来越多的外科医生将其作为一种治疗选择。外科机器人的设计目的多种多样，例如允许远程手术和消除颤抖等人为因素。本研究旨在通过对现有文献进行系统评价，评估经口机器人手术（TORS）与开放手术相比的安全性和有效性。
我们对现有文献进行了系统评价，以评估 TORS 与开放手术相比的安全性和有效性。我们根据分为 3 组的 16 个结果比较了 TORS 和开放手术：术中并发症、术后并发症以及功能和肿瘤学结果。使用以下数据库对观察性研究进行了电子检索：MEDLINE、EMBASE、Cochrane 对照试验中心注册库、Cochrane 口腔健康组试验注册库和 Scielo。数据分析按照系统评价和荟萃分析的首选报告项目（PRISMA）进行，使用纽卡斯尔-渥太华量表评估研究质量。未施加语言限制。
从确定的 4 项研究中（纽卡斯尔-渥太华量表平均得分为 6.5），共纳入 371 例患者（186 例患者接受 TORS 治疗，185 例患者接受常规手术）。总体而言，与开放手术相比，TORS 似乎具有更好的功能结果（住院时间更短、拔管）和更少的术中及术后并发症。当比较两种技术的肿瘤学结果（阳性切缘、生存率）时，并无显著差异。
与常规治疗相比，TORS 具有整体更好的功能结果，术中及术后并发症更少，阳性切缘和生存率无差异。
