Transoral robotic surgery for oropharyngeal squamous cell carcinoma

A prospective study of feasibility and functional outcomes

Eric J. Moore, Kerry D. Olsen, Jan Kasperbauer

Research output: Contribution to journalArticle

226 Citations (Scopus)

Abstract

Objectives/Hypothesis: To investigate the feasibility of transoral robotic surgery as a method of surgical treatment of oropharyngeal squamous cell carcinoma. Study Design: Prospective case study. Methods: Forty-five patients with previously untreated oropharyngeal squamous cell carcinoma underwent transoral robotic surgical removal of the tumor with or without neck dissection and with or without adjuvant therapy. Patients were observed and data were recorded on surgical time, blood loss, surgical complications, tracheostomy tube course, enteral feeding, and resumption of oral diet, speech outcomes, swallowing outcomes, and tumor recurrence. Results: All 45 patients underwent complete transoral robotic surgical excision with simultaneous unilateral or bilateral neck dissection. Margins were negative for tumor. Mean operating time for tumor removal was 71.3 minutes for the last 35 cases. There were 15 stage T1 tumors, 18 T2 tumors, 3 T3 tumors, and 9 T4a tumors. Twenty-six patients had base of tongue primary tumors and 19 had tonsillar fossa tumors. Fourteen patients had a tracheostomy tube placed at surgery, and all patients had their tracheostomy tube removed (mean duration of use, 7.0 days). Twenty-two patients (48.9%) had a nasogastric feeding tube placed, and all patients had their feeding tube removed (mean duration of use, 12.5 days). Eight patients had percutaneous gastrostomy (PEG) tubes placed, and all eight eventually had their PEG tubes removed (mean duration of use, 140.3 days). Average hospital stay was 3.8 days. There were no major complications and no procedure was aborted because of an inability to remove the tumor. Conclusions: Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal neoplasms. Advantages of the technique include adequate ability to visualize and manipulate with two hands lesions in the base of tongue. Patients were able to retain or rapidly regain oropharyngeal function in the majority of cases.

Original languageEnglish (US)
Pages (from-to)2156-2164
Number of pages9
JournalLaryngoscope
Volume119
Issue number11
DOIs
StatePublished - Nov 1 2009

Fingerprint

Robotics
Squamous Cell Carcinoma
Prospective Studies
Neoplasms
Tracheostomy
Enteral Nutrition
Neck Dissection
Gastrostomy
Tongue
Surgical Blood Loss
Oropharyngeal Neoplasms
Aptitude
Deglutition
Operative Time
Length of Stay
Therapeutics
Hand
Diet
Recurrence

Keywords

  • Base of tongue cancer
  • Oropharyngeal cancer
  • Tonsillar cancer
  • Transoral robotic surgery
  • Transoral surgery

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Transoral robotic surgery for oropharyngeal squamous cell carcinoma : A prospective study of feasibility and functional outcomes. / Moore, Eric J.; Olsen, Kerry D.; Kasperbauer, Jan.

In: Laryngoscope, Vol. 119, No. 11, 01.11.2009, p. 2156-2164.

Research output: Contribution to journalArticle

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abstract = "Objectives/Hypothesis: To investigate the feasibility of transoral robotic surgery as a method of surgical treatment of oropharyngeal squamous cell carcinoma. Study Design: Prospective case study. Methods: Forty-five patients with previously untreated oropharyngeal squamous cell carcinoma underwent transoral robotic surgical removal of the tumor with or without neck dissection and with or without adjuvant therapy. Patients were observed and data were recorded on surgical time, blood loss, surgical complications, tracheostomy tube course, enteral feeding, and resumption of oral diet, speech outcomes, swallowing outcomes, and tumor recurrence. Results: All 45 patients underwent complete transoral robotic surgical excision with simultaneous unilateral or bilateral neck dissection. Margins were negative for tumor. Mean operating time for tumor removal was 71.3 minutes for the last 35 cases. There were 15 stage T1 tumors, 18 T2 tumors, 3 T3 tumors, and 9 T4a tumors. Twenty-six patients had base of tongue primary tumors and 19 had tonsillar fossa tumors. Fourteen patients had a tracheostomy tube placed at surgery, and all patients had their tracheostomy tube removed (mean duration of use, 7.0 days). Twenty-two patients (48.9{\%}) had a nasogastric feeding tube placed, and all patients had their feeding tube removed (mean duration of use, 12.5 days). Eight patients had percutaneous gastrostomy (PEG) tubes placed, and all eight eventually had their PEG tubes removed (mean duration of use, 140.3 days). Average hospital stay was 3.8 days. There were no major complications and no procedure was aborted because of an inability to remove the tumor. Conclusions: Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal neoplasms. Advantages of the technique include adequate ability to visualize and manipulate with two hands lesions in the base of tongue. Patients were able to retain or rapidly regain oropharyngeal function in the majority of cases.",
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