Abstract：
The widespread acceptance of robotic surgery is extending to oral procedures. The demand for minimally invasive techniques is driving research into the cosmetic and oncologic benefits of robotic neck surgery. This study used propensity score matching to analyze the clinical course and postoperative outcomes of robot-assisted neck dissections for oncologic efficacy and surgical safety. Between May 2020 and April 2024, 200 OSCC patients underwent surgery and 42 were excluded. The cohort included 158 patients, 128 of whom underwent unilateral neck dissection and 30 of whom underwent bilateral neck dissection. Robotic-assisted neck dissection (RAND) was performed in 36 patients while conventional transcervical neck dissection (CTND) was performed in 122 patients. Data analysis included several factors, including lymph node retrieval and perioperative outcomes, with 1:1 propensity score matching to ensure fairness. Each of the 39 neck specimens with 36 patients was selected. The CTND group was 8 years older overall than the RAND group, but otherwise similar in terms of primary site and clinical stage. The RAND group had a 55-min longer operative time and 140 cc more hemovac drainage than the CTND group, but the hospital stay and intensive care unit duration were the same, and the number of lymph nodes retrieved was the same. Survival rates also showed no difference across all stages. This shows that RAND is in no way inferior to CTND in terms of perioperative or oncologic outcomes, and demonstrates the safety of robot-assisted surgery, even in patients who require flaps or in patients with advanced stages.
摘要：
机器人手术的广泛接受正在扩展到口腔手术。对微创技术的需求正在推动对机器人颈部手术的美容和肿瘤学益处的研究。这项研究使用倾向评分匹配来分析机器人辅助颈部淋巴结清扫术的临床过程和术后结果，以提高肿瘤疗效和手术安全性。在2020年5月至2024年4月之间，200名OSCC患者接受了手术，其中42名被排除在外。该队列包括158名患者，其中128人进行了单侧颈清扫术，其中30人进行了双侧颈清扫术。36例患者进行了机器人辅助颈淋巴结清扫术（RAND），而122例患者进行了常规经颈淋巴结清扫术（CTND）。数据分析包括几个因素，包括淋巴结取出和围手术期结果，1:1倾向得分匹配，以确保公平性。选择39个颈部标本中的每一个和36个患者。CTND组比RAND组大8岁，但在原发部位和临床分期方面相似。RAND组的手术时间比CTND组长55分钟，血流引流量多140cc，但是住院时间和重症监护病房的时间是一样的，并且取出的淋巴结数量相同。存活率在所有阶段也没有差异。这表明RAND在围手术期或肿瘤学结果方面绝不逊于CTND，并展示了机器人辅助手术的安全性，即使是需要皮瓣的患者或晚期患者。
