PDF(Pubmed)
Abstract：
Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success and failure of TORS have not been analyzed to date. In this retrospective observational multicenter cohort study, we evaluated patients treated with TORS using the da Vinci surgical system. Success criteria were defined as identification of the primary tumor for CUP, >2 mm resection margin for malignant conditions, and improvement on respiratory polygraphy and tonsillitis complaints for benign conditions. A total of 220 interventions in 211 patients were included. We identified predictors of success, such as low comorbidity status ACE-27, positive P16 status, and lower age for CUP, and female gender and OSA severity for benign conditions. For other malignancies, no predictors for success were found. Predictors of failure based on postoperative complications included high comorbidity scores (ASA) and anticoagulant use, and for postoperative pain, younger age and female gender were identified. This study provides valuable insights into the outcomes and predictors of success and failure in TORS procedures across various conditions and may also help in patient selection and counseling.
摘要：
经口机器人手术（TORS）用于治疗各种恶性肿瘤，例如早期口咽癌和未知原发肿瘤（CUP）的淋巴结转移，还有良性疾病，如阻塞性睡眠呼吸暂停（OSA）和慢性舌扁桃体炎。然而,迄今为止，尚未对TORS的成功和失败进行分析。在这项回顾性观察多中心队列研究中，我们评估了使用达芬奇手术系统接受TORS治疗的患者.成功标准定义为CUP原发肿瘤的鉴定，>2毫米的恶性情况下，切缘，以及改善良性疾病的呼吸道息肉和扁桃体炎投诉。共纳入211例患者中的220例干预措施。我们确定了成功的预测因素，如低共病状态ACE-27，阳性P16状态，CUP的年龄较低，良性疾病的女性性别和OSA严重程度。对于其他恶性肿瘤，没有发现成功的预测因素。基于术后并发症的失败预测因素包括高合并症评分（ASA）和抗凝剂使用，术后疼痛，年龄较小,性别为女性.这项研究为各种条件下的TORS程序的成功和失败的结果和预测因素提供了有价值的见解，也可能有助于患者的选择和咨询。
