Department of Plastic and Reconstructive Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2022 Aug;63(8):759-766. doi: 10.3349/ymj.2022.63.8.759.
Robotic head and neck surgery is widespread nowadays. However, in the reconstruction field, the use of robotic operations is not. This article aimed to examine methodologies for conventional head and neck reconstruction after robotic tumor surgery in an effort to obtain further options for future reconstruction manipulations.
A retrospective review of all patients who received head and neck robot surgery and conventional reconstructive surgery between October 2016 and September 2021.
In total, 53 cases were performed. 67.9% of the tumors were greater than 4 cm. Regarding defect size, 47.2% of the lesions were greater than 8 cm. In terms of TNM stage, stage 3 disease was recorded in 26.4% and stage 4 in 52.8%. To make a deep and narrow field wider, we changed the patient's posture in pre-op field, additional dissection was done. We used radial forearm flap mostly (62.2%).
Conventional head and neck reconstruction after robotic ENT cancer surgery is possible. One key step is to secure additional space in the deep and narrow space left after robotic surgery. For this, we opted for a radial forearm flap mostly. This can be performed as a bridgehead to perform robotic head and neck reconstruction.
机器人头颈部手术如今已广泛应用。然而，在重建领域，机器人手术的应用并不广泛。本文旨在探讨机器人肿瘤手术后进行常规头颈部重建的方法，以期为未来的重建操作提供更多选择。
对 2016 年 10 月至 2021 年 9 月期间接受头颈部机器人手术和常规重建手术的所有患者进行回顾性分析。
共进行了 53 例手术。67.9%的肿瘤大于 4cm。关于缺损大小，47.2%的病变大于 8cm。在 TNM 分期方面，记录到 3 期疾病占 26.4%，4 期疾病占 52.8%。为了使深部狭窄的术野更宽，我们在术前改变患者的体位，进行额外的解剖。我们主要使用桡侧前臂皮瓣（62.2%）。
机器人耳鼻喉科癌症手术后进行常规头颈部重建是可行的。关键步骤之一是在机器人手术后留下的深部狭窄空间中确保额外的空间。为此，我们主要选择桡侧前臂皮瓣。这可以作为桥接物来进行机器人头颈部重建。
