Int J Med Robot - Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery.

Tópicos

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Resumo

CKGROUND: Transoral laser microsurgery (TLM) is a mature approach to supraglottic cancer, while transoral robotic surgery (TORS) is emerging. The present study compared these approaches.METHODS: The first 10 patients (2002-2005) given TLM were compared with the first 10 (2007-2011) given TORS for cT1-3 cN0-cN2c supraglottic cancer.RESULTS: A feeding tube was used in four TLM and seven TORS patients. Margins were more often positive, but operating times shorter, in TORS. All 10 TORS patients are without evidence of disease, but only six TLM patients remain disease-free after much longer follow-up. TORS was considerably less uncomfortable and fatiguing for the surgeon.CONCLUSIONS: TORS seems as safe and effective as TLM. Shorter TORS operating times are probably attributable to prior experience with TLM. For laryngeal exposure, length of tube placement and margin evaluability, TLM was superior; however, this may change as TORS develops and transoral robotic instruments are optimized.

Resumo Limpo

ckground transor laser microsurgeri tlm matur approach supraglott cancer transor robot surgeri tor emerg present studi compar approachesmethod first patient given tlm compar first given tor ct cncnc supraglott cancerresult feed tube use four tlm seven tor patient margin often posit oper time shorter tor tor patient without evid diseas six tlm patient remain diseasefre much longer followup tor consider less uncomfort fatigu surgeonconclus tor seem safe effect tlm shorter tor oper time probabl attribut prior experi tlm laryng exposur length tube placement margin evalu tlm superior howev may chang tor develop transor robot instrument optim

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