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首页> 外文期刊>Journal of robotic surgery >Transoral robotic surgery and transoral laser microsurgery for oropharyngeal squamous cell cancer
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Transoral robotic surgery and transoral laser microsurgery for oropharyngeal squamous cell cancer

机译：经口机器人手术和经口激光显微手术治疗口咽鳞状细胞癌

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The aim of our study was to compare transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) for primary resection of oropharyngeal squamous cell cancer (OPSCC). This was a retrospective chart analysis of 33 patients with OPSCC treated at one academic medical center with either TORS (n = 17) or TLM (n = 16) between July 2008 and December 2010. Six patients in the TLM group and seven patients in the TORS group had primary cancer of the tonsil; the remaining patients had base of tongue cancer. Two patients in the TORS group had Stage I or II disease; the other 31 patients had Stage III [1/16 (6 %) TLM; 5/17 (29 %) TORS] or Stage IV cancer [15/16 (94 %) TLM; 10/17 (59 %) TORS]. The intervention was transoral surgery for OPSCC, and the main outcome measures were perioperative variables and functional outcomes. Mean operative time was 170 versus 115 min for TLM and TORS, respectively (p = 0.057). One patient, in the TLM group, required a temporary tracheostomy. Perioperative feeding tubes were placed in 6/16 (38 %) patients who underwent TLM and in 4/17 (24 %) patients who underwent TORS (p = 0.465). At a median follow-up of 14.5 months, the average MD Anderson Dysphagia Inventory score was 65.2 for TLM and 70.8 for TORS (p = 0.431). All TORS procedures were performed with a single oral retractor, while multiple laryngoscopes were required in 9/16 (56 %) TLM cases (p = 0.0003). The mean number of total specimens were 6.2 for TORS and 13.6 for TLM (p = 0.002). These results demonstrate that TLM and TORS have comparable perioperative variables with no significant differences in functional outcomes. For a subset of patients, TORS reduced the spatial complexity of surgery, suggested by the decreased need for multiple laryngoscopes, fewer specimens, and shorter operative times, while larger tumors were more amenable to TLM.
机译：我们研究的目的是比较经口激光显微手术（TLM）和经口机器人手术（TORS）对口咽鳞状细胞癌（OPSCC）的主要切除。这是一项回顾性图表分析，分析了2008年7月至2010年12月在一个学术医疗中心接受TORS（n = 17）或TLM（n = 16）治疗的33例OPSCC患​​者。TLM组中的6例患者和TLM组中的7例患者。 TORS组患有原发性扁桃体癌;其余患者患有舌癌。 TORS组中的两名患者患有I或II期疾病;其余31例患者为III期[1/16（6％）TLM; 5/17（29％）TORS]或IV期癌症[15/16（94％）TLM; 10/17（59％）TORS]。干预为OPSCC的经口手术，主要结局指标为围手术期变量和功能结局。 TLM和TORS的平均手术时间分别为170和115分钟（p = 0.057）。 TLM组中的一名患者需要进行临时气管切开术。在接受TLM的6/16（38％）患者和接受TORS的4/17（24％）患者中放置围手术期喂食管（p = 0.465）。中位随访时间为14.5个月时，TLM的平均MD Anderson吞咽困难评分得分为65.2，TORS的平均得分为70.8（p = 0.431）。所有TORS程序均使用单个口腔牵开器进行，而9/16（56％）TLM病例需要使用多个喉镜（p = 0.0003）。 TORS的总样本平均数为6.2，TLM的平均样本数为13.6（p = 0.002）。这些结果表明，TLM和TORS具有可比较的围手术期变量，功能结局无明显差异。对于部分患者，TORS减少了手术的空间复杂性，这是由于减少了对多个喉镜的需求，减少了标本，缩短了手术时间，而较大的肿瘤更适合TLM。

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