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经口机器人手术在头颈部重建中的应用

Transoral Robotic Surgery (TORS) in Head and Neck Reconstruction.

作者信息

Song Sophia Sijia, Lee Z-Hye, Yu Jessie Zexi

机构信息

Albany Medical College, Albany, NY 12208, USA.

UT MD Anderson Cancer Center, Houston, TX 77030, USA.

出版信息

J Clin Med. 2025 Aug 15;14(16):5775. doi: 10.3390/jcm14165775.

Abstract

Transoral robotic surgery (TORS) has advanced treatment for complex oropharyngeal cancers (OPC) by offering minimally invasive, precise approaches, initially for ablative and now for reconstructive procedures. This review examines TORS in OPC reconstruction, comparing it to traditional methods and presenting a TORS case with free flap reconstruction in recurrent OPC. A PubMed review assessed TORS-based reconstruction outcomes, technical challenges, and innovations. Additionally, a recurrent OPC case was treated with TORS resection and lateral arm free flap. Surgical techniques and outcomes were detailed. TORS is associated with reduced morbidity and length of hospitalization, and showed positive functional outcomes in primary, salvage, and post-radiation cases. Our case achieved favorable oncologic and functional outcomes, such as preserved speech and swallowing. TORS-based reconstruction represents a major advancement in minimally invasive head and neck oncology, providing comparable oncologic outcomes to open surgery with fewer complications. Although technically demanding, TORS is promising for complex reconstructions, warranting further research to refine techniques and standardize protocols.

摘要

经口机器人手术(TORS)通过提供微创、精确的方法,推动了复杂口咽癌(OPC)的治疗发展,最初用于消融手术,现在也用于重建手术。本综述探讨了TORS在OPC重建中的应用,将其与传统方法进行比较,并展示了一例复发性OPC采用游离皮瓣重建的TORS病例。通过PubMed检索评估了基于TORS的重建结果、技术挑战和创新。此外,对一例复发性OPC病例采用TORS切除和外侧臂游离皮瓣进行治疗,并详细介绍了手术技术和结果。TORS与发病率降低和住院时间缩短相关,在原发性、挽救性和放疗后病例中均显示出良好的功能结果。我们的病例取得了良好的肿瘤学和功能结果,如保留了言语和吞咽功能。基于TORS的重建代表了微创头颈肿瘤学的一项重大进展,与开放手术相比,其肿瘤学结果相当,但并发症更少。尽管技术要求较高,但TORS在复杂重建方面具有前景,值得进一步研究以完善技术并规范操作流程。

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