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口咽鳞状细胞癌的经口非机器人手术

Transoral non-robotic surgery for oropharyngeal squamous cell carcinoma.

作者信息

Tirelli Giancarlo, Zucchini Simone, D'Alessandro Andrea, Polesel Jerry, Giudici Fabiola, Marcuzzo Alberto Vito, Boscolo-Rizzo Paolo, Gardenal Nicoletta

机构信息

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.

SS ORL San Vito al Tagliamento - Azienda Sanitaria Friuli Occidentale, Via Savorgnano 2, 33078 San Vito al Tagliamento, Pordenone, Italy.

出版信息

Am J Otolaryngol. 2024 Nov-Dec;45(6):104504. doi: 10.1016/j.amjoto.2024.104504. Epub 2024 Aug 30.

Abstract

PURPOSE

This retrospective cohort study aims to evaluate the clinical, oncological, and functional outcomes of transoral non-robotic surgery for oropharyngeal squamous cell carcinoma (OPSCC).

MATERIALS AND METHODS

Data from 131 patients with surgically treated OPSCC (2010-2022) were analyzed. Patients who underwent exclusively transoral surgery were included in the study. The surgeries were performed under microscopic or endoscopic guidance and either a CO laser or an ultrasound/radiofrequency scalpel was used as a cutting instrument, depending on the characteristics and location of the tumor. Functional outcomes were assessed in terms of length of hospital stay, tracheostomy rate, duration of feeding tube dependency and complications. Survival outcomes were assessed in terms of overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).

RESULTS

Of 74 included patients, transoral surgery demonstrated safety with no major complications. Tracheotomy was performed in 51.4 % of cases, and was maintained for a median of 10 days. Complete swallowing recovery was restored in 97.3 % of cases, after a median of 5 days. The median length of hospital stay was 12 days. At 5 years, OS was 68.2 %, PFS was 58.2 % and DSS was 83.6 %.

CONCLUSION

The study confirms the safety and efficacy of a transoral approach for OPSCC. Having the capability to utilize and access a variety of tools provides the opportunity to tailor the technique to the individual patient and specific circumstances.

摘要

目的

本回顾性队列研究旨在评估经口非机器人手术治疗口咽鳞状细胞癌(OPSCC)的临床、肿瘤学和功能结局。

材料与方法

分析了131例接受手术治疗的OPSCC患者(2010 - 2022年)的数据。仅接受经口手术的患者纳入本研究。手术在显微镜或内镜引导下进行,根据肿瘤的特征和位置,使用CO2激光或超声/射频手术刀作为切割工具。从住院时间、气管切开率、鼻饲管依赖持续时间和并发症方面评估功能结局。从总生存(OS)、无病生存(DFS)和疾病特异性生存(DSS)方面评估生存结局。

结果

在纳入的74例患者中,经口手术显示出安全性,无重大并发症。51.4%的病例进行了气管切开,中位持续时间为10天。97.3%的病例在中位5天后完全恢复吞咽功能。中位住院时间为12天。5年时,OS为68.2%,PFS为58.2%,DSS为83.6%。

结论

本研究证实了经口手术治疗OPSCC的安全性和有效性。具备使用和获取各种工具的能力为根据个体患者和具体情况调整技术提供了机会。

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