经口机器人辅助喉上部分切除术的手术、肿瘤学和功能结果。

Surgical, Oncological, and Functional Outcomes of Transoral Robotic Supraglottic Laryngectomy.

机构信息

Robotic Study Group of Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.

Department of Otorhinolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.

出版信息

Laryngoscope. 2021 May;131(5):1060-1065. doi: 10.1002/lary.28926. Epub 2020 Jul 23.

DOI:10.1002/lary.28926

PMID:32812245

Abstract

OBJECTIVES/HYPOTHESIS: To investigate the surgical, oncological, and functional outcomes of transoral robotic surgery (TORS) for the treatment of supraglottic squamous cell carcinoma.

STUDY DESIGN

Retrospective chart review.

METHODS

The charts of patients treated by TORS supraglottic laryngectomy (SGL) in an academic medical center were reviewed. The following outcomes were studied according to the tumor location: average robotic setup and operative times, mean estimated blood loss, postoperative complications, need of tracheotomy, refeeding characteristics, mean hospital stay, need of neck dissection and adjuvant therapy, 5-year local and regional controls, overall survival (OS), and disease-free survival (DFS).

RESULTS

Seventy-five patients underwent TORS SGL. Tumors were classified as cT1 (32%), cT2 (52%), and cT3 (16%). Average robotic setup and operative times and the mean estimated blood loss were 15 minutes, 55 minutes, and 20 mL, respectively. The mean follow-up period ranged from 2 to 5 years. The 5-year OS and DFS were 80.2% and 94.3%, respectively. Overall, 34.6% of patients received adjuvant radiotherapy. The majority of patients (92%) restarted an oral diet within 24 to 48 hours postsurgery. Transient tracheotomy was performed in 8% of patients. Postoperative hemorrhages occurred in 12 patients (16.0%), lengthening the hospital stay (mean = 6.8 days). There were no outcome differences regarding the tumor location.

CONCLUSIONS

TORS is an effective and safe therapeutic approach for early- and intermediate-stages cancers. Oncological outcomes may be quite similar to other surgical approaches, including transoral laser and open surgeries. Future randomized controlled studies are needed for comparing TORS SGL with other surgical procedures.

LEVEL OF EVIDENCE

4 Laryngoscope, 131:1060-1065, 2021.

摘要

目的/假设：研究经口机器人手术（TORS）治疗声门上型鳞状细胞癌的手术、肿瘤学和功能结果。

研究设计

回顾性图表审查。

方法

在学术医疗中心，对接受经口机器人声门上喉切除术（SGL）治疗的患者的图表进行了回顾。根据肿瘤位置研究了以下结果：平均机器人设置和手术时间、平均估计失血量、术后并发症、气管切开需要、再喂养特征、平均住院时间、颈清扫术和辅助治疗的需要、5 年局部和区域控制、总生存率（OS）和无病生存率（DFS）。

结果

75 例患者接受了 TORS SGL。肿瘤分为 cT1（32%）、cT2（52%）和 cT3（16%）。平均机器人设置和手术时间以及平均估计失血量分别为 15 分钟、55 分钟和 20 毫升。平均随访时间范围为 2 至 5 年。5 年 OS 和 DFS 分别为 80.2%和 94.3%。总体而言，34.6%的患者接受了辅助放疗。大多数患者（92%）在手术后 24 至 48 小时内恢复口服饮食。8%的患者行暂时性气管切开术。12 例（16.0%）患者发生术后出血，延长了住院时间（平均=6.8 天）。肿瘤位置对结果没有影响。