CT1-T3上laryngeal癌症的跨口腔机器人手术的手术，功能和肿瘤学结果：系统评价
Surgical, Functional, and oncological outcomes of transoral robotic surgery for cT1-T3 supraglottic laryngeal Cancers: A systematic review
影响因子:3.90000
分区:医学2区 / 牙科与口腔外科2区 肿瘤学3区
发表日期:2024 Dec
作者:
Jérôme R Lechien
摘要
This systematic review investigated the surgical, functional, and oncological outcomes of transoral robotic supraglottic laryngectomy (TORS-SGL) for cT1-T3 laryngeal squamous cell carcinoma (LSCC).Two investigators conducted an updated PubMed, Scopus, and Cochrane Library systematic review for studies investigating the surgical, functional, and oncological outcomes of使用Prisma语句的TORS-SGL。包括二十一项研究，占896名患者，包括二十一项研究。 TORS-SGL主要是针对CT1（39.1％），CT2（46.9％）和一些选定的CT3（7.7％）LSCC进行的。在10.8％的病例中，手术边缘为阳性。平均住院时间为8.6天。出血（6.3％），肺炎（5.5％）和抽吸（1.7％）是主要并发症。 10.6％的病例中，手术边缘为正。在65.6％，19.7％和5.2％的患者中发现进食管，临时气管切开术和明确的经皮胃造口术。平均7.2天后重新启动口服饮食。 TORS-SGL的5年OS和DFS估计为78.3％，和91.7％，5年的无局部无透明剂存活率和无节性无骨的生存率分别为90.8％，TORS-SGL是安全的，有效的手术方法是CT1-T3 SGL。功能和手术结果似乎与TOLM-SGL相当。 TORS-SGL的肿瘤学结果可能比TOLM和开放的SGL更好，但是需要进一步的大量队列控制研究来得出可靠的结论。
Abstract
This systematic review investigated the surgical, functional, and oncological outcomes of transoral robotic supraglottic laryngectomy (TORS-SGL) for cT1-T3 laryngeal squamous cell carcinoma (LSCC).Two investigators conducted an updated PubMed, Scopus, and Cochrane Library systematic review for studies investigating the surgical, functional, and oncological outcomes of TORS-SGL using the PRISMA statements. The bias analysis was conducted with the MINORS.Twenty-one studies were included, accounting for 896 patients. TORS-SGL was primarily performed for cT1 (39.1 %), cT2 (46.9 %), and some selected cT3 (7.7 %) LSCCs. Surgical margins were positive in 10.8 % of cases. The mean hospital stay was 8.6 days. Hemorrhage (6.3 %), pneumonia (5.5 %), and aspiration (1.7 %) are the primary complications. The surgical margins were positive in 10.6 % of cases. Feeding tubes, temporary tracheotomy, and definitive percutaneous gastrostomy are found in 65.6 %, 19.7 %, and 5.2 % of patients, respectively. The oral diet is restarted after a mean of 7.2 days. The 5-year OS and DFS of TORS-SGL were estimated to be 78.3 %, and 91.7 %, with 5-year local-relapse-free survival and nodal-relapse-free survival of 90.8 %, and 86.6 %, respectively.The TORS-SGL is a safe, and effective surgical approach for cT1-T3 SGL. The functional and surgical outcomes appear comparable with TOLM-SGL. The oncological outcomes of TORS-SGL could be better than TOLM and open SGLs, but further large cohort-controlled studies are needed to draw reliable conclusions.