PDF(Pubmed)
Abstract：
Trans Oral Robotic Surgery (TORS) is a modality in the management of oropharyngeal squamous cell carcinoma(OPSCC). This study was conducted to show the rates of peri-operative complications after TORS for OPSCC in our experience. Single centre retrospective analysis of consecutive OPSCC treated with TORS. The surgical complication severity was recorded according to Clavien-Dindo criteria (CDC). Eighty-seven OPSCC were operated with TORS. According to CDC, grade I, grade II and IIIb were registered in 8%, 4.6% and 11.5% of cases, respectively. The postoperative pain, registered with visual-analogue scale (VAS) score, was 8 ± 1.2 for the secondary healing wounds and 6.2 ± 1.5 for the flap reconstructions (p < 0.01). The impact on swallowing function was not significant between secondary healing and flap reconstructions(p = 0.96). Any major or life-threatening intraoperative complications have not been recorded. Only one patient had postoperative bleeding into the neck whilst 13.3% of patients had postoperative bleeding from the primary tumor. No total local or free flap failure were registered. The mean duration of tracheostomy use was 7.4 ± 2.6 days, and nasogastric tube 14.3 ± 6.9 days. Only one patient, who had also reconstruction with flap, experienced a postoperative severe dysphagia with severe aspiration, needing a permanent tracheostomy tube and percutaneous endoscopic gastrostomy feeding. TORS for OPSCC showed less morbidity, lower risk of severe complication and mortality. Thus, this treatment modality could be offered as first line treatment in selected cases.
摘要：
经口机器人手术（TORS）是治疗口咽鳞状细胞癌（OPSCC）的一种方式。根据我们的经验，进行这项研究是为了显示OPSCCTORS术后围手术期并发症的发生率。采用TORS治疗的连续OPSCC的单中心回顾性分析。根据Clavien-Dindo标准（CDC）记录手术并发症的严重程度。87个OPSCC用TORS进行手术。根据CDC,I级,二级和二级的登记率为8%，4.6%和11.5%的病例，分别。术后疼痛,与视觉模拟量表(VAS)评分配准，二次愈合伤口为8±1.2，皮瓣重建为6.2±1.5（p<0.01）。二次愈合和皮瓣重建对吞咽功能的影响不显著(p=0.96)。尚未记录任何严重或危及生命的术中并发症。只有一名患者术后颈部出血，而13.3％的患者术后原发性肿瘤出血。没有记录到完全的局部或游离皮瓣失败。气管造口术的平均使用时间为7.4±2.6天，鼻胃管14.3±6.9天。只有一个病人,他也用皮瓣重建，经历了术后严重吞咽困难和严重的误吸，需要永久性气管造口管和经皮内镜胃造瘘术喂养。OPSCC的TORS显示发病率较低，降低严重并发症和死亡率的风险。因此，在选定的病例中，这种治疗方式可以作为一线治疗。
