Transoral Robotik Supraglottik Larenjektomi

Yıl 2016, Cilt: 2 Sayı: 2, 113 - 118, 01.01.2016

Murat Turhan Aslı Bostancı

https://izlik.org/JA43RS23CN

Öz

amaç: Transoral robotik cerrahi TORC supraglottik larenks kanserlerinin endolarengeal tedavisinde minimal invaziv yeni bir yöntemdir. Çalışmanın amacı transoral robotik supraglottik larenjektomi uyguladığımız iki hastadaki ilk tecrübelerimizi paylaşmaktır. Gereç ve Yöntemler: Erken evre supraglottik kanserli iki hasta TORC için seçildi. Hastaların preoperatif, intraoperatif ve postoperatif yönetimi literatür derlemesi eşliğinde sunuldu. Bulgular: Tümörlü larenks dokusu her iki hastada da cerrahi sınırlar negatif halde en-blok rezeke edildi. Hastalar postoperatif birinci günde ekstübe edildiler. Yedinci günde dekanülize edilerek oral beslenmeye başlandılar. Onuncu günde yutma fonksiyonları tamamen düzeldi. Birinci hasta postoperatif 20. gün, ikincisi ise 14. günde sorunsuz taburcu edildi. Perioperatif ve postoperatif komplikasyon izlenmedi.Sonuç: Transoral robotic supraglottik larenjektomi iyi seçilmiş supraglottik larenks kanserli olgularda güvenilir ve etkin bir tedavi seçeneğidir. Uzun dönem fonksiyonel ve onkolojik sonuçlarını değerlendirmek için geniş olgu serilerini içeren ileri araştırmalara ihtiyaç vardır

Anahtar Kelimeler

Larenks kanseri , Transoral robotik cerrahi , Minimal invaziv teknik

Transoral Robotik Supraglottik Larenjektomi

https://izlik.org/JA43RS23CN

Öz

Objective: Transoral robotic surgery TORS is a minimally invasive new technique for the endolaryngeal treatment of supraglottic larynx cancers. The aim of this study was to present our initial experiences with transoral robotic supraglottic laryngectomy performed in two cases. Material and Methods: Two patients with early stage supraglottic cancer were selected for TORS. The preoperative, intraoperative and postoperative management of patients were presented with a literature review. Results: Laryngeal tumor tissue was resected en bloc with negative surgical margins in both patients. Patients were extubated on postoperative day one. They were decannulated and started to be fed orally on postoperative day seven. Swallowing functions were recovered completely on postoperative day 10. No perioperative or postoperative complications were observed. The first case was discharged uneventfully on postoperative day 20, and the second case on postoperative day 14.Conclusion: Transoral robotic supraglottic laryngectomy is a safe and effective treatment choice in well–selected patients with supraglottic larynx cancer. Further trials with a larger cohort of patients are needed for evaluation of long-term functional and oncological outcomes

Anahtar Kelimeler

Laryngeal cancer , Transoral robotic surgery , Minimal invasive technique

Kaynakça

• Chu EA, Kim YJ. Laryngeal cancer: Diagnosis and preoperative work-up. Otolaryngol Clin North Am 2008; 4:673-95.
• Morales-Angulo C, Val-Bernal F, Buelta L, Fernandez F, García-Castrillo L, Rama J. Prognostic factors in supraglottic laryngeal carcinoma. Otolaryngol Head Neck Surg 1998; 119:548-53.
• Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am 2008; 41:757-69.
• Back G, Sood S. The management of early laryngeal cancer: Options for patients and therapists. Curr Opin Otolaryngol Head Neck Surg 2005;13:85-91.
• Cmelak AJ, Li S, Goldwasser MA, Murphy B, Cannon M, Pinto H, Rosenthal DI, Gillison M, Forastiere AA. Phase II trial of chemoradiation for organ preservation in resectable stage III or IV squamous cell carcinomas of the larynx or oropharynx: Results of Eastern Cooperative Oncology Group Study E2399. J Clin Oncol 2007; 25:3971-7.
• Weinstein GS, O’Malley BW Jr, Snyder W, Hockstein NG. Transoral robotic surgery: Supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol 2007; 116:19- 23.
• Park YM, Byeon HK, Chung HP, Choi EC, Kim SH. Comparison of treatment outcomes after transoral robotic surgery and supraglottic partial laryngectomy: Our experience with seventeen and seventeen patients respectively. Clin Otolaryngol 2013; 38:270-4.
• Boudreaux BA, Rosenthal EL, Magnuson JS, Newman JR, Desmond RA, Clemons L, Carroll WR. Robot- assisted surgery for upper aerodigestive tract neoplasms. Arch Otolaryngol Head Neck Surg. 2009; 135:397-401.
• Iseli TA, Kulbersh BD, Iseli CE, Carroll WR, Rosenthal EL, Magnuson JS. Functional outcomes after transoral robotic Surgery for head and neck cancer. Otolaryngol Head Neck Surg 2009; 141:166-71.
• Mendelsohn AH, Remacle M, Van Der Vorst S, Bachy V, Lawson G. Outcomes following transoral robotic surgery: Supraglottic laryngectomy. Laryngoscope 2013; 123:208- 14.
• Remacle M, Hantzakos A, Eckel H, Evrard AS, Bradley PJ, Chevalier D, Djukic V, de Vincentiis M, Friedrich G, Olofsson J, Peretti G, Quer M, Werner J. Endoscopic supraglottic laryngectomy: A proposal for a classification by the working committee on nomenclature, European Laryngological Society. Eur Arch Otorhinolaryngol 2009; 266:993-8.
• Peretti G, Piazza C, Cattaneo A, De Benedetto L, Martin E, Nicolai P. Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies. Ann Otol Rhinol Laryngol 2006; 115:827-32.
• Park YM, Kim WS, Byeon HK, Lee SY, Kim SH. Surgical techniques and treatment outcomes of transoral robotic supraglottic partial laryngectomy. Laryngoscope 2013; 123:670-7.
• Kayhan FT, Kaya KH, Sayin I. Transoral robotic cordectomy for early glottic carcinoma. Ann Otol Rhinol Laryngol 2012; 121:497-502.
• Smith RV. Transoral robotic surgery for larynx cancer. Otolaryngol Clin North Am 2014; 47:379-95.
• Kayhan FT, Kaya KH, Altintas A, Sayin I. Transoral robotic supraglottic partial laryngectomy. J Craniofac Surg 2014; 25:1422-6.
• Roh JL, Kim DH, Park CI. Voice, swallowing and quality of life in patients after transoral laser surgery for supraglottic carcinoma. J Surg Oncol 2008; 98:184-9.
• Lawson G, Matar N, Remacle M, Jamart J, Bachy V. Transoral robotic surgery for the management of head and neck tumors: Learning curve. Eur Arch Otorhinolaryngol 2011; 268:1795-801.