单中心经口入路机器人手术治疗咽喉部病变的安全性及有效性
Safety and efficacy of single-center transoral robotic surgery for pharyngeal and laryngeal lesions
徐继峰 1黎奥 1王俊国 1谷全水 2钱晓云 1高下 1顾亚军1
作者信息
- 1. 南京大学医学院附属鼓楼医院耳鼻咽喉头颈外科南京鼓楼医院耳鼻咽喉研究所,江苏南京 210008
- 2. 南京大学医学院附属鼓楼医院麻醉手术科,江苏南京 210008
- 折叠
摘要
目的 对经口机器人手术(TORS)在治疗咽喉部病变中的安全性及有效性进行探讨.方法 回顾性分析2016年至2018年南京鼓楼医院行TORS治疗咽喉头颈部病变的9例患者的临床资料,其中口咽肿瘤6例,咽旁间隙肿瘤3例.分析患者的手术时间、术中出血量、术后禁食时间、术后住院天数、手术前后疼痛与吞咽困难评分、术后有无出血及神经损伤等并发症.结果 9例患者均通过TORS完成病灶切除.术后病理良性3例,恶性6例,所有切缘均为阴性.TORS手术时间为55～140(85.56±28.77)min,出血量为10～50(23.33±11.73)mL,术后住院天数为4～7(6.00±1.00)d,恢复饮食时间为1～3(1.78±0.67)d.除1名口咽癌患者术后当天出现伤口渗血,其余均未出现并发症.术后随访4～86个月,肿瘤患者无局部复发、远处转移或死亡.结论 依据本中心现有病例经验,合理选择适应证、手术方式,做好围手术期管理、术后长期随访,在一定程度上可以证实,TORS切除咽喉部病变是安全、有效的.
Abstract
Objective To explore the safety and effectiveness of transoral robotic surgery(TORS)in the treatment of pharyngeal and laryngeal lesions.Methods From 2016 to 2018,the clinical data of 9 cases underwent TORS in Nanjing Drum Tower Hospital were retrospectively analyzed,including 6 cases of oropharyngeal tumors and 3 cases of parapharyngeal space tumors.The operation time,intraoperative blood loss,postoperative fasting time,postoperative hospital stay,postoperative pain and dysphagia scores,postoperative bleeding and nerve injury and other complications were analyzed.Results All 9 patients completed the lesion resection through TORS.The postoperative pathology was benign in 3 cases and malignant in 6 cases,and all resection margins were negative.The operation time was 55-140(85.56±28.77)min.The intraoperative blood loss was 10-50(23.33±11.73)mL,no gastric tube was placed after the operation,the time to resume eating and drinking was 1-3(1.78±0.67)d,and the postoperative hospital stay was 4-7(6.00±1.00)d.Except for 1 oropharyngeal tumor patient who had bleeding from the wound on the day after operation,no complications occurred in the rest.The postoperative follow-up was 4-86 months,and there was no local recurrence,distant metastasis or death in the tumor patients.Conclusion Based on the existing case experience,it can be confirmed to a certain extent that the TORS to resection of throat lesions is safe after reasonable selection of indications and surgical methods,and perioperative and postoperative long-term follow-up effective and minimally invasive.
关键词
达芬奇机器人手术/经口机器人手术/口咽癌/咽旁间隙肿瘤Key words
da Vinci robotic surgery/Transoral robotic surgery/Oropharyngeal cancer/Parapharyngeal space tumors引用本文复制引用
基金项目
中国博士后科学基金面上项目(第六十八批)(2020M681561)
江苏省医学重点学科建设项目(十四五)(ZDXK202243)
出版年
2024
NETL
NSTL
万方数据