Archives of otolaryngology--head & neck surgery · 2007
Transoral robotic surgery: radical tonsillectomy.
Клиническое исследование I фазыСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Weinstein Gregory S, O'Malley Bert W, Snyder Wendy, Sherman Eric, Quon Harry
Аннотация
OBJECTIVE: To describe and show the feasibility of a new surgical technique for transoral robotic surgery (TORS) radical tonsillectomy.
DESIGN: A prospective, phase 1 clinical trial.
SETTING: Academic, tertiary referral center.
PATIENTS: A total of 27 participants were prospectively selected using a volunteer sample. All eligible patients agreed to participate in the study.
INTERVENTIONS: Patients underwent TORS radical tonsillectomy for previously untreated invasive squamous cell carcinoma of the tonsillar region without free-flap reconstruction, staged neck dissection, and adjuvant therapy.
MAIN OUTCOME MEASURES: Outcome measures included final pathologic margin status, need for short- and long-term tracheotomy tube placement, and need for gastrostomy tube feedings among patients with a minimum 6-month follow-up. The incidence of significant postoperative complications was recorded.
RESULTS: No mortality occurred. Final margins found to be negative for cancer were achieved in 25 of 27 patients (93%). Surgical complications included 1 case each of postoperative mucosal bleeding, delirium tremens, unplanned tracheotomy for temporary exacerbation of sleep apnea, and hypernasality and 2 cases of moderate trismus. Twenty-six of 27 patients (96%) were swallowing without the use of a gastrostomy.
CONCLUSIONS: Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity. Future reports will focus on long-term oncologic and functional outcomes.
DESIGN: A prospective, phase 1 clinical trial.
SETTING: Academic, tertiary referral center.
PATIENTS: A total of 27 participants were prospectively selected using a volunteer sample. All eligible patients agreed to participate in the study.
INTERVENTIONS: Patients underwent TORS radical tonsillectomy for previously untreated invasive squamous cell carcinoma of the tonsillar region without free-flap reconstruction, staged neck dissection, and adjuvant therapy.
MAIN OUTCOME MEASURES: Outcome measures included final pathologic margin status, need for short- and long-term tracheotomy tube placement, and need for gastrostomy tube feedings among patients with a minimum 6-month follow-up. The incidence of significant postoperative complications was recorded.
RESULTS: No mortality occurred. Final margins found to be negative for cancer were achieved in 25 of 27 patients (93%). Surgical complications included 1 case each of postoperative mucosal bleeding, delirium tremens, unplanned tracheotomy for temporary exacerbation of sleep apnea, and hypernasality and 2 cases of moderate trismus. Twenty-six of 27 patients (96%) were swallowing without the use of a gastrostomy.
CONCLUSIONS: Radical tonsillectomy using TORS is a new technique that offers excellent access for resection of carcinomas of the tonsil with acceptable acute morbidity. Future reports will focus on long-term oncologic and functional outcomes.