Abstract：
OBJECTIVE: Transoral surgery is a minimally invasive treatment but may cause severe dysphagia at a lower rate than chemoradiotherapy.
METHODS: We compared clinical information, surgical complications, and swallowing function in patients who underwent transoral nonrobotic surgery for laryngo-pharyngeal squamous cell carcinoma between 2015 and 2021 in a multicenter retrospective study.
RESULTS: Six hundred and forty patients were included. Postoperative bleeding was observed in 20 cases (3.1%), and the risk factor was advanced T category. Postoperative laryngeal edema was observed in 13 cases (2.0%), and the risk factors were prior radiotherapy, advanced T stage, and concurrent neck dissection in patients with resected HPC. Dysphagia requiring nutritional support was observed in 29 cases (4.5%) at 1 month postoperatively and in 19 cases (3.0%) at 1 year postoperatively, respectively. The risk factors for long-term dysphagia were prior radiotherapy and advanced T category. Short-term risk factors for dysphagia were prior radiotherapy, advanced T category, and concurrent neck dissection, while long-term risk factors for dysphagia were only prior radiotherapy and advanced T category.
CONCLUSIONS: Prior radiotherapy, advanced T stage, and concurrent neck dissection increased the incidence of postoperative laryngeal edema and short-term dysphagia, but concurrent neck dissection did not affect long-term dysphagia. Such features should be considered when considering the indication for transoral surgery and postoperative management.
METHODS: We compared clinical information, surgical complications, and swallowing function in patients who underwent transoral nonrobotic surgery for laryngo-pharyngeal squamous cell carcinoma between 2015 and 2021 in a multicenter retrospective study.
RESULTS: Six hundred and forty patients were included. Postoperative bleeding was observed in 20 cases (3.1%), and the risk factor was advanced T category. Postoperative laryngeal edema was observed in 13 cases (2.0%), and the risk factors were prior radiotherapy, advanced T stage, and concurrent neck dissection in patients with resected HPC. Dysphagia requiring nutritional support was observed in 29 cases (4.5%) at 1 month postoperatively and in 19 cases (3.0%) at 1 year postoperatively, respectively. The risk factors for long-term dysphagia were prior radiotherapy and advanced T category. Short-term risk factors for dysphagia were prior radiotherapy, advanced T category, and concurrent neck dissection, while long-term risk factors for dysphagia were only prior radiotherapy and advanced T category.
CONCLUSIONS: Prior radiotherapy, advanced T stage, and concurrent neck dissection increased the incidence of postoperative laryngeal edema and short-term dysphagia, but concurrent neck dissection did not affect long-term dysphagia. Such features should be considered when considering the indication for transoral surgery and postoperative management.
摘要：
目的：经口手术是一种微创治疗，但可能导致严重吞咽困难的发生率低于放化疗。
方法：我们比较了临床信息，手术并发症,一项多中心回顾性研究显示,在2015年至2021年期间接受经口非机器人手术治疗喉咽鳞状细胞癌的患者的吞咽功能.
结果：纳入了640名患者。术后出血20例(3.1%),危险因素为高级T类。术后喉头水肿13例(2.0%),危险因素是放疗前，先进的T级，以及切除HPC的患者同时进行颈清扫。术后1个月出现需要营养支持的吞咽困难29例(4.5%),术后1年出现吞咽困难19例(3.0%),分别。长期吞咽困难的危险因素是放疗前和晚期T分类。吞咽困难的短期危险因素是放疗前，高级T类,同时进行颈淋巴结清扫，而吞咽困难的长期危险因素仅是放疗前和晚期T类别。
结论：先前放疗，先进的T级，同时颈淋巴结清扫术增加了术后喉头水肿和短期吞咽困难的发生率，但同时进行颈清扫并不影响长期吞咽困难.在考虑经口手术和术后管理的适应症时，应考虑这些特征。
方法：我们比较了临床信息，手术并发症,一项多中心回顾性研究显示,在2015年至2021年期间接受经口非机器人手术治疗喉咽鳞状细胞癌的患者的吞咽功能.
结果：纳入了640名患者。术后出血20例(3.1%),危险因素为高级T类。术后喉头水肿13例(2.0%),危险因素是放疗前，先进的T级，以及切除HPC的患者同时进行颈清扫。术后1个月出现需要营养支持的吞咽困难29例(4.5%),术后1年出现吞咽困难19例(3.0%),分别。长期吞咽困难的危险因素是放疗前和晚期T分类。吞咽困难的短期危险因素是放疗前，高级T类,同时进行颈淋巴结清扫，而吞咽困难的长期危险因素仅是放疗前和晚期T类别。
结论：先前放疗，先进的T级，同时颈淋巴结清扫术增加了术后喉头水肿和短期吞咽困难的发生率，但同时进行颈清扫并不影响长期吞咽困难.在考虑经口手术和术后管理的适应症时，应考虑这些特征。
