Transoral robotic surgery in head and neck district: a retrospective study on 67 patients treated in a single center.
Head and neck surgery
Oropharynx
Trans oral robotic surgery
de-intensified treatment
Journal
Infectious agents and cancer
ISSN: 1750-9378
Titre abrégé: Infect Agent Cancer
Pays: England
ID NLM: 101276559
Informations de publication
Date de publication:
2020
2020
Historique:
received:
25
06
2019
accepted:
01
06
2020
entrez:
19
6
2020
pubmed:
19
6
2020
medline:
19
6
2020
Statut:
epublish
Résumé
The anatomical complexity of the oropharynx and the difficulty in reaching its distal portion have always conditioned the surgical accessibility.Robotic surgery represents an excellent alternative in the treatment of cervico-facial oncological diseases. This series comprises all patients managed for head and neck cancer by Trans Oral Robotic Surgery TORS.The staging assessment, including neck ultrasound and total body PET/CT scan, was performed in each patient according to the TNM classification.All charts were recorded with the following data: name and surname, age, gender, date of surgery intra or post-operative hemorragia, tumor site, histology, TNM stage, robot set-up time, tumor resection time, whether or not tracheotomy was performed, whether or not neck dissection was performed, insertion of a nasogastric tube or gastrostomy, time to resumption of oral feeding, surgical margins, mean length of hospital stay, adjuvant treatment and follow-up. From February 2013 to February 2018, TORS was performed in 67 consecutive patients affected by head and neck tumours.We divided, our sample, in 3 subsites: supraglottic larynx, parapharyngeal space and oropharynx.Pathology reports confimed malignancy in 44 cases: 8 cases lymphomas, 36 cases of Squamous cell carcinoma (SCC), 5 cases of benign salivary glands tumors and 18 miscellaneous cases. Neck dissection was performed in 12 cases.Tracheotomy was perfomed in 3/67 cases for respiratory failures. A nasogastric tube was inserted at the end of the surgical procedure in 21 patients. The mean length of hospital stay was 10 days .Major complications included post-operative bleeding in 3 patients, 1 exitus for massive bleeding 20 days post-surgery and 1 respiratory failure treated with tracheotomy and monitoring in the Intensive Care Unit (ICU) for 3 days. Robotic surgery has been considered a valid alternative to traditional open treatment in many specializations with the advantages of an endoscopic procedure, with the same oncological and functional results and with fewer complications. The advantages of this type of surgical technique have been discussed, it is mandatory to focus on the indications and contraindications.
Sections du résumé
BACKGROUND
BACKGROUND
The anatomical complexity of the oropharynx and the difficulty in reaching its distal portion have always conditioned the surgical accessibility.Robotic surgery represents an excellent alternative in the treatment of cervico-facial oncological diseases.
METHODS
METHODS
This series comprises all patients managed for head and neck cancer by Trans Oral Robotic Surgery TORS.The staging assessment, including neck ultrasound and total body PET/CT scan, was performed in each patient according to the TNM classification.All charts were recorded with the following data: name and surname, age, gender, date of surgery intra or post-operative hemorragia, tumor site, histology, TNM stage, robot set-up time, tumor resection time, whether or not tracheotomy was performed, whether or not neck dissection was performed, insertion of a nasogastric tube or gastrostomy, time to resumption of oral feeding, surgical margins, mean length of hospital stay, adjuvant treatment and follow-up.
RESULTS
RESULTS
From February 2013 to February 2018, TORS was performed in 67 consecutive patients affected by head and neck tumours.We divided, our sample, in 3 subsites: supraglottic larynx, parapharyngeal space and oropharynx.Pathology reports confimed malignancy in 44 cases: 8 cases lymphomas, 36 cases of Squamous cell carcinoma (SCC), 5 cases of benign salivary glands tumors and 18 miscellaneous cases. Neck dissection was performed in 12 cases.Tracheotomy was perfomed in 3/67 cases for respiratory failures. A nasogastric tube was inserted at the end of the surgical procedure in 21 patients. The mean length of hospital stay was 10 days .Major complications included post-operative bleeding in 3 patients, 1 exitus for massive bleeding 20 days post-surgery and 1 respiratory failure treated with tracheotomy and monitoring in the Intensive Care Unit (ICU) for 3 days.
CONCLUSIONS
CONCLUSIONS
Robotic surgery has been considered a valid alternative to traditional open treatment in many specializations with the advantages of an endoscopic procedure, with the same oncological and functional results and with fewer complications. The advantages of this type of surgical technique have been discussed, it is mandatory to focus on the indications and contraindications.
Identifiants
pubmed: 32549909
doi: 10.1186/s13027-020-00306-7
pii: 306
pmc: PMC7296635
doi:
Types de publication
Journal Article
Langues
eng
Pagination
40Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsThe authors performed all the work by themselves and declare they have no competing interests nor conflicts of interests.
Références
Arch Otolaryngol Head Neck Surg. 2001 Feb;127(2):127-32
pubmed: 11177028
ISRN Oncol. 2012;2012:945162
pubmed: 22606380
Head Neck. 2016 Apr;38 Suppl 1:E2190-6
pubmed: 25833809
J Clin Oncol. 2015 Oct 10;33(29):3285-92
pubmed: 26351337
JAMA Facial Plast Surg. 2018 Mar 1;20(2):154-159
pubmed: 29192315
Otolaryngol Head Neck Surg. 2011 Aug;145(2):248-53
pubmed: 21810777
Cancer. 2002 Jun 1;94(11):2967-80
pubmed: 12115386
Head Neck. 2012 Feb;34(2):146-54
pubmed: 21469248
Otolaryngol Clin North Am. 2012 Aug;45(4):845-61
pubmed: 22793856
JAMA Otolaryngol Head Neck Surg. 2013 Aug 1;139(8):773-8
pubmed: 23949352
Semin Laparosc Surg. 1997 Jun;4(2):102-109
pubmed: 10401147
J Clin Oncol. 2017 Feb 10;35(5):490-497
pubmed: 28029303
JAMA Otolaryngol Head Neck Surg. 2015 Dec;141(12):1043-1051
pubmed: 26402479
Eur Arch Otorhinolaryngol. 2011 Dec;268(12):1795-801
pubmed: 21365213
Arch Otolaryngol Head Neck Surg. 2012 Jul;138(7):628-34
pubmed: 22801885
Sem Hop. 1955 Feb 20;31(11):599-600
pubmed: 14358748
Laryngoscope. 2012 Aug;122(8):1701-7
pubmed: 22752997
Arch Otolaryngol Head Neck Surg. 2010 Nov;136(11):1079-85
pubmed: 21079160
BMC Cancer. 2013 Mar 20;13:133
pubmed: 23514246
Adv Otorhinolaryngol. 1988;39:135-44
pubmed: 2455969
Otolaryngol Head Neck Surg. 2009 Aug;141(2):166-71
pubmed: 19643246
Laryngoscope. 2005 Jul;115(7):1315-9
pubmed: 15995528
Laryngoscope. 2006 Feb;116(2):165-8
pubmed: 16467698
Head Neck. 2015 Sep;37(9):1304-9
pubmed: 24816480
Arch Otolaryngol Head Neck Surg. 2011 Nov;137(11):1112-6
pubmed: 22106235
Ear Nose Throat J. 2013 Feb;92(2):76-83
pubmed: 23460216
N Engl J Med. 2010 Jul 1;363(1):24-35
pubmed: 20530316
Ear Nose Throat J. 2005 Mar;84(3):170-2
pubmed: 15871586
Head Neck. 2011 Apr;33(4):573-80
pubmed: 21425382
Head Neck. 2012 Jun;34(6):886-93
pubmed: 22610591
Am J Surg. 2004 Oct;188(4A Suppl):2S-15S
pubmed: 15476646
Int J Oral Maxillofac Surg. 2018 Aug;47(8):971-975
pubmed: 29397299
BMC Cancer. 2015 Aug 27;15:602
pubmed: 26311526
J Clin Oncol. 2013 Feb 10;31(5):520-2
pubmed: 23295808
Arch Otolaryngol Head Neck Surg. 2007 Dec;133(12):1220-6
pubmed: 18086963
Eur Arch Otorhinolaryngol. 2015 Feb;272(2):463-71
pubmed: 24643851
Oral Oncol. 2017 Apr;67:160-166
pubmed: 28351571
Head Neck. 2016 Apr;38 Suppl 1:E776-82
pubmed: 25916790
Laryngoscope. 2014 Sep;124(9):2096-102
pubmed: 24729006
Eur Ann Otorhinolaryngol Head Neck Dis. 2011 Dec;128(6):290-6
pubmed: 21955463
Eur J Cancer. 2016 Nov;68:125-133
pubmed: 27755996