Ueda Tsutomu, Taruya Takayuki, Hattori Minoru, Chikuie Nobuyuki, Sato Yuki, Hattori Takayoshi, Hamamoto Takao, Ishino Takashi, Takeno Sachio
Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
Center for Medical Education Institute of Biomedical & Health Sciences, Hiroshima University, Hiroshima 734-8551, Japan.
Cancers (Basel). 2025 Apr 25;17(9):1446. doi: 10.3390/cancers17091446.
Transoral robotic surgery (TORS) is a minimally invasive procedure that is performed with neck dissection (ND) and postoperative radiotherapy when necessary. This study aimed to review the methods of vascular ligation and ND in cases of TORS for oropharyngeal cancer in Japan.
We enrolled 44 consecutive patients who underwent TORS for laryngopharyngeal cancer between December 2019 and December 2023. Of these, 35 patients who underwent TORS as a first-line treatment for oropharyngeal cancer were included in this study. We retrospectively collected patient data on age, sex, primary tumor location, clinical tumor-node classification, Eastern Cooperative Oncology Group performance status, history of irradiation to the neck, presence of anticoagulants, pathological results, tumor size, total operative duration, console time, length of skin incision operative result, estimated blood loss, late cervical lymph node metastasis, perioperative complications, postoperative hospital stay, postoperative bleeding, period until oral intake after surgery, and swallowing function. Intra- and postoperative outcomes of TORS, TORS + ND (IIa) + vascular ligation, and TORS + ND (II-IV) + vascular ligation.
Significant differences were found in operative duration, blood loss during ND, and skin incision length between TORS + ND (IIa) + vascular ligation and TORS + ND (II-IV) + vascular ligation. Console time and blood loss did not significantly differ between the two groups. Each group contained one case of postoperative bleeding.
Safe and minimally invasive treatments can be established if vascular ligation and ND are implemented based on appropriate case selection.
经口机器人手术（TORS）是一种微创手术，必要时可结合颈部淋巴结清扫术（ND）及术后放疗进行。本研究旨在回顾日本口咽癌TORS病例中血管结扎和ND的方法。
我们纳入了2019年12月至2023年12月期间连续接受TORS治疗喉咽癌的44例患者。其中，35例将TORS作为口咽癌一线治疗的患者纳入本研究。我们回顾性收集了患者的年龄、性别、原发肿瘤位置、临床肿瘤-淋巴结分类、东部肿瘤协作组体能状态、颈部放疗史、抗凝剂使用情况、病理结果、肿瘤大小、总手术时长、控制台操作时间、皮肤切口长度、手术结果、估计失血量、晚期颈部淋巴结转移、围手术期并发症、术后住院时间、术后出血、术后至经口进食的时间以及吞咽功能等数据。TORS、TORS + ND（IIa）+血管结扎以及TORS + ND（II-IV）+血管结扎的术中和术后结果。
TORS + ND（IIa）+血管结扎与TORS + ND（II-IV）+血管结扎在手术时长、ND期间的失血量和皮肤切口长度方面存在显著差异。两组之间的控制台操作时间和失血量无显著差异。每组均有1例术后出血病例。
如果根据适当的病例选择实施血管结扎和ND，可以建立安全且微创的治疗方法。
