Department of Otolaryngology - Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Department of Otolaryngology - Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, 27599, USA.
Int J Pediatr Otorhinolaryngol. 2024 Sep;184:112073. doi: 10.1016/j.ijporl.2024.112073. Epub 2024 Aug 15.
Provide an update on our institution's experience with utilizing transoral robotic surgery (TORS) in pediatric airway surgery and compare these results to surgery by traditional methods.
Pediatric patients who underwent TORS for treatment of upper airway pathology between 2010 and 2021 at our institution were retrospectively identified and compared to patients with the same or similar pathology who underwent a traditional (open or endoscopic) surgical approach over the same time period. Outcomes of interest included patient demographics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow (MBSS) results.
Forty children (19M, 21F) underwent 46 TORS procedures. Mean age was 6.4 years (range: 6 days-17 years). Most commonly treated pathology included: laryngeal clefts (LC) (n = 18), lymphatic malformations (n = 9), and base of tongue masses (n = 7). Surgical time was decreased in traditional type I LC repairs (mean: 111 vs 149 min, P = 0.04) and lymphatic malformation excisions (59 vs 120 min, p = 0.005). Hospital LOS was increased in TORS type I LC repairs (2.6 vs 1.2 days, P = 0.04). Adverse event rate was similar between TORS and traditional cohorts (17 % vs 16 % cases, P = 0.9). Postoperative MBSS results were improved for TORS type I LC repairs at 6 months (70 % vs 33 %, P = 0.09) and 12 months (82 % vs 43 %, P = 0.05).
Pediatric TORS is practical and safe and has comparable outcomes to traditional surgery. Robotic-assisted LC repair displayed improved postoperative swallow results versus traditional approaches and may be particularly useful in recurrent cases.
介绍我们机构在儿童气道手术中应用经口机器人手术（TORS）的经验，并将这些结果与传统方法进行比较。
回顾性分析了 2010 年至 2021 年期间在我院接受 TORS 治疗上气道病变的儿科患者，并与同期接受传统（开放或内镜）手术治疗的具有相同或相似病理的患者进行比较。感兴趣的结果包括患者人口统计学、手术时间、不良事件、住院时间（LOS）和改良钡吞咽（MBSS）结果。
40 例儿童（男 19 例，女 21 例）共进行 46 例 TORS 手术。平均年龄为 6.4 岁（范围：6 天至 17 岁）。最常见的治疗病变包括：喉裂（LC）（n=18）、淋巴管畸形（n=9）和舌根肿块（n=7）。传统型 I 型 LC 修复术（平均手术时间：111 分钟比 149 分钟，P=0.04）和淋巴管畸形切除术（59 分钟比 120 分钟，P=0.005）的手术时间缩短。TORS 型 I 型 LC 修复术的住院时间增加（2.6 天比 1.2 天，P=0.04）。TORS 组和传统组的不良事件发生率相似（17%比 16%，P=0.9）。TORS 型 I 型 LC 修复术后 6 个月（70%比 33%，P=0.09）和 12 个月（82%比 43%，P=0.05）的 MBSS 结果改善。
儿科 TORS 是一种实用且安全的方法，其结果与传统手术相当。机器人辅助 LC 修复术与传统方法相比，术后吞咽功能改善，在复发性病例中可能特别有用。
