Long-term outcomes of trans-oral robotic surgery-assisted total laryngectomy for recurrent laryngeal cancers
| Autor: | Jia-Shiou Liao, Shih-An Liu, Chen-Chi Wang, Sheng-Hwa Chen, Armando De Virgilio, Wen-Jiun Lin |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Fistula Operative Time Laryngectomy 03 medical and health sciences 0302 clinical medicine Robotic Surgical Procedures Swallowing Transoral robotic surgery medicine Humans Radiology Nuclear Medicine and imaging Robotic surgery Longitudinal Studies 030223 otorhinolaryngology Laryngeal Neoplasms Aged Retrospective Studies business.industry Hyoid bone Neck dissection Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Treatment Outcome Oncology 030220 oncology & carcinogenesis Neck Dissection Neoplasm Recurrence Local business |
| Zdroj: | Japanese Journal of Clinical Oncology. 50:653-660 |
| ISSN: | 1465-3621 |
| Popis: | Objective For recurrent laryngeal cancers, trans-oral robotic surgery has been used to perform total laryngectomy, but limited cases had been reported without long-term outcome follow-up. This study aims at presenting the largest longitudinal retrospective cohort in a single tertiary referral medical center. Methods From November 2013 to August 2017, seven patients with recurrent laryngeal cancers without evidence of neck metastasis were selected to receive trans-oral robotic surgery-assisted TL without neck dissection. The para-operative details including the surgical success rates, surgical methods, resection extent, drainage tube placement, pharyngeal wound closure, console surgical time, pathologic findings and long-term complications were reviewed and described. The study end points include survival rates and preservation of swallowing function without tube feeding. Results Trans-oral robotic surgery-assisted total laryngectomy was successfully performed on all seven patients with mean surgical console time of 111 ± 66 min. Strap muscles and hyoid bone were resected like open surgery in six and five patients, respectively. For all the seven patients, there was no severe pharyngo-cutaneous fistula formation requiring repair in a second surgery, but tracheostoma stenosis was not uncommon (57%). Three patients received adjuvant chemotherapy/radiotherapy. After follow-up of 36.1 ± 15.8 months, two patients had neck recurrence, and one patient died 19 months after surgery, but the other five patients were alive without disease recurrence. The overall survival rate was 85.7% (6/7), and all patients had good swallowing function without tube feeding. Conclusions Trans-oral robotic surgery-assisted total laryngectomy is a feasible approach for selected patients with recurrent laryngeal cancers. The oncologic and functional outcomes were satisfactory. Further larger cohort study is worthwhile to further elucidate the value of trans-oral robotic surgery-assisted total laryngectomy. |
| Databáze: | OpenAIRE |
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