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Robot-assisted surgery acceptable for oropharyngeal tumor resection
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A retrospective case-controlled study found that robotic-assisted surgery was effective for patients undergoing surgical resection for T1 and T2 oropharyngeal cancer.
“Management of head and neck carcinoma has traditionally required extensive open resection to obtain access to the posterior oral cavity and oropharynx,” the researchers wrote. “These procedures result in considerable speech and swallowing dysfunction for many patients as well as poor cosmesis.” Using robotic-assisted techniques provides a minimally invasive alternative.
In this study, the researchers compared results from 36 patients who underwent resection between 2001 and 2008. Fifteen patients underwent robotic-assisted surgery for primary neoplasms, seven underwent robotic-assisted salvage surgery for recurrent disease and 14 had open salvage resection for recurrent disease.
Patients in the open salvage group had a longer median hospital stay than the other groups: 8.2 days compared with five days in the robotic salvage group (P=.14) and 1.5 days in the robotic-assisted primary group (P<.001).
In the open salvage surgery group, 43% were dependent on gastronomy tubes for six months compared with none in the robotic salvage group (P=.06).
In addition, although there were no differences in postoperative diet between patients undergoing robotic primary and robotic salvage surgery, 43% of those patients who had open salvage surgery were gastrostomy tube dependent six months postoperative.
There were no complications reported in the robotic salvage group; in the robotic primary group, two patients developed postoperative bleeding at the resection site, one patient was reintubated due to airway edema and one patient developed pneumonia. In the open salvage group, two patients developed wound infections, one developed a neck abscess and two developed postoperative hematomas.
“Although robotic salvage therapy may not be reasonable for advanced T category disease, it appears to be safe and feasible for the treatment of select T1 and T2 oropharyngeal neoplasms as an alternative to open salvage resection,” the researchers wrote. They noted that further study is needed to examine long-term outcomes.
For more information:
- Dean NR. Arch Otolaryngol Head Neck Surg. 2010;136:380-384.