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Robotic surgery shows promise for removal of voice box tumors
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Transoral robotic surgery through the mouth is a safe and effective procedure for patients with head and neck cancers, according to results of a preliminary prospective study.
Patients with laryngopharyngeal carcinomas who wish to avoid potentially damaging toxicities associated with standard radiotherapy and chemotherapy treatments are beginning to trend toward minimally invasive organ preservation surgeries, such as transoral robotic surgery (TORS) for the removal of the top part of the voice box, called supraglottic laryngectomy.
Previous studies have examined the advantages of the TORS procedure compared with traditional treatments. These advantages include the avoidance of the external incision, preservation of nontumor-involved structures and shorter hospitalizations.
Researchers investigated the efficiency, safety and functional outcomes of TORS for supraglottic laryngectomy.
For the study, Enver Ozer, MD, clinical associate professor of otolaryngology for the Arthur G. James Cancer Hospital at the Ohio State University Comprehensive Cancer Center, and colleagues identified 126 patients who underwent TORS between April 2008 and November 2011.
The researchers examined 13 patients with squamous cell carcinoma who underwent TORS between the base of the tongue and above the vocal cords, called the supraglottic region.
The mean age of the patients was 58.1 years, and mean follow-up time was 6.8 months.
Within 24 hours of surgery, 11 patients started an oral diet with no evidence of immediate airway compromise.
It took 24.2 minutes to set up for the TORS procedure, and the procedure lasted a mean operating room time of 25.3 minutes. In contrast, the removal of tumors by open surgery on the neck can take upward of 4 hours to perform.
Blood loss was minimal, with the TORS intraoperative blood loss estimated at 15.4 mL, according to researchers.
Patients encountered no surgical complications and averaged 3.9 days of hospitalization.
“The transoral robotic technique means shorter surgery, less time under anesthesia, a lower risk of complications and shorter hospital stays for these patients,” Ozersaid in a press release. “It also means no external surgical incisions for the patient and better 3-D visualization of the tumor for the surgeon.”
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