Zhang Y B, Rai R A I, Zhi Y H, Zhang B
Department of Head and Neck Surgery, Peking University Cancer Hospital & Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Beijing 100142, China.
Department of General Surgery, Bejing United Family Hospital, Beijing 100015, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 May 7;57(5):559-564. doi: 10.3760/cma.j.cn115330-20210813-00548.
To investigate the oncological and functional efficacy and safety of transoral robotic surgery (TORS) in the treatment of oropharyngeal carcinoma. Twenty-six patients with oropharyngeal cancer were enrolled who underwent TORS at Beijing United Hospital from June 1, 2017 to December 31, 2020. Among them, 22 patients were males and 4 were females, aged 39 to 76 years old. T1-2 patients accounted for 88.5% (23/26). Clinicopathological data including the time of removal of gastric and endotracheal tube were collected. The SPSS software package was used for survival analysis, and the overall survival rate and disease-free survival rate were calculated. All the 26 patients with oropharyngeal cancer received TORS without conversion to open surgery, and 20 of them underwent simultaneous cervical lymph node dissection. TORS operation time ranged from 65 to 360 minutes with an average of 215 minutes. Intraoperative blood loss ranged from 5 to 600 ml with an average of 70 ml. Four patients (15.4%) underwent tracheotomy, of whom 3 patients had the removals of tracheal tubes within 1 month after surgery and 1 case remained to wear a tube by the end of follow-up. Twelve patients (46.2%) underwent gastric tube implantation, among them, 11 patients had removals of gastric tubes within 1 month after surgery and 1 patient died of oropharyngeal hemorrhage 13 days after operation. One patient (3.8%) had a positive surgical margin and others had pathologically negative surgical margins. Sixteen patients (61.5%) received postoperative radiotherapy, of whom 11 patients (42.3%) received platinum-based concurrent chemotherapy. The median follow-up time was 21.5 months (0.4 to 45 months). The overall survival and the disease-free survival rates were 83.0% and 75.8%, respectively. The application of TORS in treatment of oropharyngeal cancer can achieve good oncological and functional outcomes in selected patients.
探讨经口机器人手术（TORS）治疗口咽癌的肿瘤学疗效、功能疗效及安全性。选取2017年6月1日至2020年12月31日在北京联合医院接受TORS治疗的26例口咽癌患者。其中男性22例，女性4例，年龄39至76岁。T1 - 2期患者占88.5%（23/26）。收集包括胃管和气管导管拔除时间在内的临床病理资料。采用SPSS软件包进行生存分析，计算总生存率和无病生存率。26例口咽癌患者均接受TORS治疗，无一例转为开放手术，其中20例同时行颈部淋巴结清扫。TORS手术时间为65至360分钟，平均215分钟。术中出血量为5至600毫升，平均70毫升。4例患者（15.4%）行气管切开术，其中3例患者术后1个月内拔除气管导管，1例患者随访结束时仍带管。12例患者（46.2%）行胃管植入术，其中11例患者术后1个月内拔除胃管，1例患者术后13天死于口咽出血。1例患者（3.8%）手术切缘阳性，其余患者手术切缘病理阴性。16例患者（61.5%）接受术后放疗，其中11例患者（42.3%）接受铂类同步化疗。中位随访时间为21.5个月（0.4至45个月）。总生存率和无病生存率分别为83.0%和75.8%。TORS应用于口咽癌治疗，在部分患者中可取得良好的肿瘤学和功能学疗效。
