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机器人耳后入路颈清扫术的解剖、技术和结果。

Anatomy, technique, and results of robotic retroauricular approach to neck dissection.

机构信息

Head and Neck Surgery Department, University of Sao Paulo Medical School, Sao Paulo, Brazil.

Head and Neck Surgery and Otorhinolaryngology Department, A. C. Camargo Cancer Center, Sao Paulo, Brazil.

出版信息

Anat Rec (Hoboken). 2021 Jun;304(6):1235-1241. doi: 10.1002/ar.24621. Epub 2021 Mar 26.

Abstract

In the attempt to improve the cosmetic and functional outcomes in head and neck surgeries, robotic or video-assisted neck dissection using remote access has gained ground in recent years. Retroauricular approach emerged as the most versatile option, allowing proper dissection at all neck levels. In this technique, after retroauricular incision, a skin flap is elevated and a self-retaining retractor is placed, creating working space for the robotic, or endoscopic neck dissection. Numerous published series have shown the safety and favorable outcomes of retroauricular robotic neck dissections, without any major complications or surgery-related deaths. The only consistently reported disadvantage is a longer operative time. Our group has an experience of 190 retroauricular neck dissections performed over the last 5 years, without any major setbacks. The oncologic and safety outcomes have been comparable to the conventional technique, with clearly superior aesthetic results. In the process of expansion of Robotic Surgery in Brazil, our center is currently providing training and proctoring to capacitate other head and neck surgeons, and enable other centers to offer this surgical modality.

摘要

近年来,为了改善头颈部手术的美容和功能效果,远程控制机器人或视频辅助的颈部解剖术已经取得了进展。耳后入路成为应用最广泛的选择,可在所有颈部水平进行适当的解剖。在该技术中,于耳后切开后,掀起皮瓣,放置自固定牵开器,为机器人或内镜颈部解剖术创造工作空间。大量已发表的系列研究表明,耳后机器人颈部解剖术具有安全性和良好的效果,没有任何重大并发症或与手术相关的死亡。唯一一致报道的缺点是手术时间较长。我们小组在过去 5 年中进行了 190 例耳后颈部解剖术,没有任何重大挫折。肿瘤学和安全性结果与传统技术相当,具有明显优越的美容效果。在巴西机器人手术不断扩张的过程中,我们中心目前正在提供培训和指导,以使其他头颈部外科医生具备能力,并使其他中心能够提供这种手术方式。

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