Transoral robotic surgery in management of oropharyngeal cancers: a preliminary experience at a tertiary cancer centre in India

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• 作者：Surender Dabas ; Abhinav Dewan ; Reetesh Ranjan…
• 关键词：TORS ; Oropharyngeal cancer ; DaVinci Robot ; Head and neck cancers
• 刊名：International Journal of Clinical Oncology
• 出版年：2015
• 出版时间：August 2015
• 年：2015
• 卷：20
• 期：4
• 页码：693-700
• 全文大小：531 KB
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• 作者单位：Surender Dabas (1)
  Abhinav Dewan (2)
  Reetesh Ranjan (1)
  Ajay Kumar Dewan (1)
  Anoop Puri (1)
  Swati H. Shah (1)
  Rupal Sinha (3)
  
  1. Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India
  2. Department of Radiation Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India
  3. Department of Research, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Oncology
  Surgical Oncology
  Radiotherapy
  Diagnostic Radiology
  Internal Medicine
  Pathology
  
• 出版者：Springer Japan
• ISSN：1437-7772

文摘

Background The aim of this observational prospective study was to determine the technical feasibility, safety and adequacy of surgical margins for transoral robotic surgery (TORS) in oropharyngeal cancers. Methods From March 2013 to May 2014, 60 patients with oropharyngeal lesions underwent TORS with or without neck dissection using the ‘DaVinci-robot. Patients were observed and data recorded on surgical time, blood loss, complications and functional outcome of patients. Results All 60 patients underwent TORS, with neck dissection performed in 45 of the patients. A positive margin was seen in two patients (3.3?%). Intent to treatment was radical in 42 patients and salvage in 18 patients. None of the patients required tracheostomy, and one patient (1.66?%) died postoperatively. Postoperative complications in the form of primary haemorrhage required active intervention in three patients. Average estimated blood loss was 26.5?±?31.1?ml. Postoperatively, all patients had adequate swallowing and speech function with nasal twang reported in three patients on long-term follow up. Patients started tolerating oral feeds within a week of procedure (mean 3.96?days), with the nasogastric tube removed on the ninth postoperative day (mean 9.19?days). No long-term gastrostomy tube dependency was reported. Conclusion TORS is a safe, feasible, minimally invasive procedure in patients with oropharyngeal cancers. It has the least morbidity and offers benefits in terms of avoidance of tracheostomy tube, prolonged Ryle’s tube and gastrostomy dependency.