Retropharyngeal lymphadenectomy with transoral robotic surgery for papillary thyroid cancer

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• 作者：Michael W. Moore (1)
  Kitti Jantharapattana (2)
  Michelle D. Williams (3)
  David G. Grant (4)
  Jesse C. Selber (5)
  F. Christopher Holsinger (1)
  
• 关键词：Transoral robotic surgery ; TORS ; Head and neck surgery ; Minimally invasive surgery ; Retropharyngeal lymphadenectomy
• 刊名：Journal of Robotic Surgery
• 出版年：2011
• 出版时间：September 2011
• 年：2011
• 卷：5
• 期：3
• 页码：221-226
• 全文大小：473KB
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• 作者单位：Michael W. Moore (1)
  Kitti Jantharapattana (2)
  Michelle D. Williams (3)
  David G. Grant (4)
  Jesse C. Selber (5)
  F. Christopher Holsinger (1)
  
  1. Department of Head and Neck Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030-4009, USA
  2. Department of Otolaryngology Head and Neck Surgery, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
  3. Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030-4009, USA
  4. Mayo Clinic, Department of Otolaryngology-Head and Neck Surgery and Audiology, Jacksonville, FL, 32224, USA
  5. Department of Plastic Surgery, University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030-4009, USA
  

文摘

Retropharyngeal metastasis of papillary thyroid carcinoma is a rare but well recognized phenomenon. Traditional open surgical approaches to nodal metastasis located in the retropharyngeal space are particularly morbid considering the relatively indolent nature of some thyroid cancers. Minimally invasive surgical approaches offer a useful alternative that is both low in morbidity and high in levels of patient acceptance. To assess feasibility and safety, we report a case series of robotic lymphadenectomy in two patients with thyroid cancer metastatic to the retropharyngeal space. Two patients, ages 66 and 73, with unilateral recurrent papillary carcinoma of the retropharyngeal lymph nodes had previously undergone thyroidectomy, neck dissection, and radioactive iodine ablation prior to retropharyngeal resection. Retropharyngeal lymphadenectomy via transoral robotic surgery was performed for both patients: for the first, the oropharyngeal wound was left to heal by secondary intention, while for the other patient, simple pharyngeal flap closure was performed. Retropharyngeal lymph node dissections were successfully carried out using a transoral robotic retropharyngotomy with the da Vinci surgical robotic system. Both patients tolerated the procedure well. One patient did developed temporary dysphagia which resolved with conservative measures, not requiring a feeding tube. We report the first two cases of transoral robot-assisted resection of thyroid cancer metastatic to the retropharyngeal lymph nodes. The technique is feasible, minimally invasive, and appears to be as safe as conventional surgical methods in achieving the goals of management of regionally metastatic disease.