以經口機器手臂手術治療咽喉癌之初步經驗

Transoral Robotic Surgery in Cancers of Oropharynx, Larynx and Hypopharynx-A Preliminary Result

沈士傑(Shih-Chieh Shen) ； 辛立仁(Li-Jen Hsin) ； 方端仁(Tuan-Jen Fang)

《台灣耳鼻喉頭頸外科雜誌》 50卷1期 (2015/03) Pp. 11-18

https://doi.org/10.6286/2015.50.1.11

摘要

經口機器手臂手術（transoral robotic surgery, TORS）近年來在咽喉癌之治療開始扮演舉足輕重的角色。由於目前並無本土相關文獻，我們回顧本院兩年來以TORS進行咽喉患者之治療結果，分享TORS於治療咽喉癌之初步成效。方法：本研究為回溯性病例統計分析。我們收集於本院接受TORS切除咽喉癌且已追蹤超過1年之病患，並就病患之臨床資料，腫瘤位置、併發症級腫瘤，且皆無手術相關之併發症發生。1名患者於術後第9個月因肺炎死亡，其餘病人經追蹤超過1年仍存活且無局部復發的情況，所有病人皆無長期鼻胃管之依賴。結論：TORS具有良好安全性、早期控制率，經慎選病患，完整術前評估後，可視為咽喉癌可行的治療方式之一。隨著設備與手術技術的進步，預期在未來咽喉癌的治療上將可有更廣泛的應用

關鍵字

經口機器手臂手術 ； 咽喉癌 ； 機器手臂手術

並列摘要

Background: Transoral robotic surgery (TORS) has been an emerging technique in the treatment of pharyngolaryngeal cancer. It is important to evaluate the treat outcomes among Taiwanese patients. This study reviewed the preliminary treatment outcomes for patients with laryngopharyngeal cancer treated with TORS in our institution during the past 2 years. Methods: This is a retrospective cases study. Patients who accepted TORS for treatment of laryngopharyngeal cancer and being followed up for at least 1 year were recruited. We collected the patients' demographic data, location of the tumor, complications, local control of tumor and survival outcomes. Results: Ten patients with supraglottic (3), hypopharyngeal (1), tongue base (4), tonsillar (1), and soft palatal (1) cancer were enrolled in our study. The treatment modality for one patient with supraglottic lesion had been switched to concurrent chemoradiation due to failure of proper exposure intraoperatively owing to glottic and subglottic invasion of the primary tumor. Nine out of ten patients receiving TORS completed tumor resection and no intraoperative or perioperative complication occurred. There was no primary tumor local recurrence found among the 9 patients after one year follow-up and all patients survived except for one patient died from aspiration pneumonia at the 9th month post-op. None of the 9 patients had long-term nasogastric tube dependency. Conclusions: TORS can be served as a proper treatment option for oropharyngeal hypopharyngeal, and laryngeal cancers in terms of safety and early primary tumor control. With the continuous advancement of decreasing size of the surgical equipment and further improvement of surgical technique, we can anticipate that TORS will be widely applied in the treatment of laryngopharyngeal cancers.

並列關鍵字

transoral robotic surgery ； laryngopharyngeal cancer ； robotic surgery