文章：

经口机器人手术治疗口咽癌中血管结扎预防术中和术后出血的疗效

Efficacy of Vascular Ligation for the Prevention of Intra- and Postoperative Bleeding in Transoral Robotic Surgery for Oropharyngeal Cancer

原文发布日期：25 April 2025

DOI: 10.3390/cancers17091446

类型: Article

开放获取: 是

英文摘要：

Background: Transoral robotic surgery (TORS) is a minimally invasive procedure that is performed with neck dissection (ND) and postoperative radiotherapy when necessary. This study aimed to review the methods of vascular ligation and ND in cases of TORS for oropharyngeal cancer in Japan. Methods: We enrolled 44 consecutive patients who underwent TORS for laryngopharyngeal cancer between December 2019 and December 2023. Of these, 35 patients who underwent TORS as a first-line treatment for oropharyngeal cancer were included in this study. We retrospectively collected patient data on age, sex, primary tumor location, clinical tumor–node classification, Eastern Cooperative Oncology Group performance status, history of irradiation to the neck, presence of anticoagulants, pathological results, tumor size, total operative duration, console time, length of skin incision operative result, estimated blood loss, late cervical lymph node metastasis, perioperative complications, postoperative hospital stay, postoperative bleeding, period until oral intake after surgery, and swallowing function. Intra- and postoperative outcomes of TORS, TORS + ND (IIa) + vascular ligation, and TORS + ND (II–IV) + vascular ligation. Results: Significant differences were found in operative duration, blood loss during ND, and skin incision length between TORS + ND (IIa) + vascular ligation and TORS + ND (II–IV) + vascular ligation. Console time and blood loss did not significantly differ between the two groups. Each group contained one case of postoperative bleeding. Conclusions: Safe and minimally invasive treatments can be established if vascular ligation and ND are implemented based on appropriate case selection.

摘要翻译： 

背景：经口机器人手术（TORS）是一种微创手术，必要时会联合颈淋巴结清扫术（ND）及术后放疗。本研究旨在回顾日本口咽癌TORS手术中血管结扎与颈淋巴结清扫的方法。方法：我们纳入了2019年12月至2023年12月期间连续接受TORS治疗喉咽癌的44例患者，其中35例将TORS作为口咽癌一线治疗的患者纳入本研究。我们回顾性收集了患者的年龄、性别、原发肿瘤部位、临床肿瘤-淋巴结分期、东部肿瘤协作组体能状态、颈部放疗史、抗凝药物使用情况、病理结果、肿瘤大小、总手术时长、控制台操作时间、皮肤切口长度、手术结果、估计失血量、晚期颈部淋巴结转移、围手术期并发症、术后住院时间、术后出血情况、术后至经口进食时间以及吞咽功能等数据。比较了单纯TORS、TORS联合ND（IIa区）及血管结扎、TORS联合ND（II–IV区）及血管结扎三组患者的术中及术后结果。结果：TORS联合ND（IIa区）及血管结扎组与TORS联合ND（II–IV区）及血管结扎组在手术时长、颈清扫术中失血量及皮肤切口长度方面存在显著差异，而控制台操作时间和总失血量在两组间无显著差异。每组各出现1例术后出血病例。结论：在恰当的病例选择基础上实施血管结扎与颈淋巴结清扫，可以建立安全且微创的治疗方案。

原文链接：

Efficacy of Vascular Ligation for the Prevention of Intra- and Postoperative Bleeding in Transoral Robotic Surgery for Oropharyngeal Cancer