Colevas Sophia M, Merfeld Emily C, Pflum Zachary E, Gessert Thomas G, Wieland Aaron M, Glazer Tiffany A, Burr Adam R, Harari Paul M, Hartig Gregory K
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
Department of Human Oncology University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA.
OTO Open. 2023 Feb 23;7(1):e35. doi: 10.1002/oto2.35. eCollection 2023 Jan-Mar.
The aim of this study was to evaluate our institutional experience with the combined transoral plus lateral pharyngotomy (TO+LP) approach in a subset of patients with advanced or recurrent oral and oropharyngeal malignancy.
A retrospective study of procedures utilizing TO+LP for cancer resection between January 2007 and July 2019.
Tertiary academic medical center.
Thirty-one patients underwent a TO+LP approach for the resection of oral and oropharyngeal tumors. Functional and oncologic outcomes were analyzed.
Eighteen (58.1%) patients were treated with TO+LP for recurrent disease. Twenty-nine required free tissue transfer and 2 (6.5%) had positive margins. The median time to decannulation was 22 days (range 6-100 days). Thirteen (41.9%) patients still required enteral feeding at their most recent follow-up. Patients without a history of prior radiation were decannulated sooner ( = .009) and were less likely to require enteral feeding at the first postoperative follow-up ( = .034) than those who had prior head and neck radiotherapy.
A TO+LP approach can be used to achieve good functional and oncologic results for selected patients with advanced or recurrent oral and oropharyngeal cancer when minimally invasive options such as transoral robotic surgery, transoral laser microsurgery, or radiotherapy are not possible.
本研究的目的是评估我们机构采用经口联合外侧咽切开术（TO+LP）治疗晚期或复发性口腔及口咽恶性肿瘤患者的经验。
对2007年1月至2019年7月间采用TO+LP进行癌症切除手术的回顾性研究。
三级学术医疗中心。
31例患者接受了TO+LP手术以切除口腔和口咽肿瘤。分析功能和肿瘤学结局。
18例（58.1%）患者因复发性疾病接受TO+LP治疗。29例需要游离组织移植，2例（6.5%）切缘阳性。拔管的中位时间为22天（范围6 - 100天）。13例（41.9%）患者在最近一次随访时仍需要肠内营养。与有头颈部放疗史的患者相比，无既往放疗史的患者拔管更快（P = 0.009），且术后首次随访时需要肠内营养的可能性更小（P = 0.034）。
当经口机器人手术、经口激光显微手术或放疗等微创选择不可行时，TO+LP方法可用于为选定的晚期或复发性口腔及口咽癌患者取得良好的功能和肿瘤学效果。
