minimally invasive procedures for laryngeal carcinoma transoral endoscopic laser and transoral robotic surgery ozgul topal资料.pdf

该【minimally invasive procedures for laryngeal carcinoma transoral endoscopic laser and transoral robotic surgery ozgul topal资料 】是由【四婆子】上传分享，文档一共【4】页，该文档可以免费在线阅读，需要了解更多关于【minimally invasive procedures for laryngeal carcinoma transoral endoscopic laser and transoral robotic surgery ozgul topal资料 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。TurkishArchivesofOtorhinolaryngologyTurkArchOtorhinolaryngol2017;55:34-734TürkOtorinolarengolojiAr?iviMinimallyInvasiveProceduresforLaryngealCarcinoma:TransoralEndoscopicLaserandTransoralRoboticSurgery?zgülTopalReviewDepartmentofOtorhinolaryngology,Ba?kentUniversitySchoolofMedicine,Ankara,TurkeyAbstractOpenpartialortotallaryngectomieswithorwithoutlaryngealframeworkisnotdisturbedintheseproce-radiotherapy(RT)orchemoradiotherapy(CRT)aredures;therefore,thepostoperativeswallowingfuncti-theonlymainstaysinthetreatmentoflaryngealcarci-onimprovesmorerapidly,,,theyhaveoncologicalarbondioxidelasermicrosur-(TLM)ortransoralroboticsurgeries(TRS)areKeywords:Laryngealcarcinoma,lasersurgery,,minimallyinvasivesurgicalproceduresIntroductionapplicationintheoutpatientstatus,shortertreat-Foryears,etheonlymentperiod,repetitioninrecurrences,,import-cases,opportunitytoperformsalvagepartialopenantsurgicalimprovementshavebeenperformedsurgeryafterTLMifneeded,andnoneedoftra-(3).Withthemorewidespreadsurgicaluseofmicro-scope,endoscope,andlaseratpresent,essfulInTLM,delicateincisionsperformedwithlaserfunctionalandoncologicresultsinlaryngealcar-,postoperativespeechandswallowingmicrosurgery(TLM)and/ortransoralroboticsur-functionsarepreservedatthehighestpossiblelev-geries(TRS).el,,thissituationoftenleadstopositivesurgicalmar-ClinicalandResearchImpactsginsduetoa1--efTransorallasermicrosurgeryisaminimallyinva-fectsofthispositivityonlocalcontrolandsurvivalsivesurgeryperformedusingsurgicalmicroscope,,andsurgicalcarbondi-routinesecond-looklaryngoscopy,thehighcostoxide(CO2)-negativesurgicalspeci-1972,StrongandJako(1)-AddressforCorrespondence:?zgülTopalapproachofresectingatumorinpiecesratherthancedure(4).Forsolvingthisproblem,-mail:******@ordingtotraditionaloncologicrules(5)mendedfrozen-sectionbiopsyasanReceivedDate::,itisbeingincreasinglyusedbe-alternativetosecond-looklaryngoscopyduringthe?-sectionbiopsy,SocietyofOtorhinolaryngologyandHeadandNeckSurgeryAvailableonlineatdamagetoswallowingandspeechfunctions(2).whichistakenduringtransorallaserlaryngecto-aredtoradiotherapy(RT)andopenpartialmy,andthoseofaroutinehistopathologicalexam-DOI:.1930laryngectomy,theadvantagesofTLMincludetheinationareconsistentattherateofapproximatelyTurkArchOtorhinolaryngol2017;55:34-7Topal?.MinimallyInvasiveProceduresforLaryngealCarcinoma3594%(6).Thesefindingsindicatethatfrozen-missureinvolvement(T1b),,.(7)onTLMpatients,ithasbeenstat-Intheoncologicevaluationofresults,theratesoftwo-yearlocaledthatalthoughnegativemarginswereobtainedwithrepeatedcontrolforTLMandRTwerefoundtobe95%%,excisionsinthesamesessioninpatientswhosefrozen-sectionrespectively;theratesoflarynxpreservationwere100%andresultswerepositiveinthefirstsurgery,%,respectively;andtheratesofdisease-freesurvivalwereparedtopa-%%,-thatthefollow-upcontrolsofthesepatientsshouldbeconduct--looklaryn-missureinvolvement,’sinabilitytoestimatetumormarginsexactlyplannedsecond-looksurgeryallowsearlydetectionofpossibleordinglysurgicalmarginpositivitycanberecurrences(16).explainedwithpossiblefieldcancerizationorpossiblesubmuco-salspreadbeyondtheclinicallyandmicroscopicallyidentifiableHinnietal.(17),evenifexcisionsarerepeateduntilnegativewithfive-yearfollow-upandreportedthatthelarynxwaspre-marginsareobtainedwithfrozensectionbiopsyinthefirstsur-servedattherateof92%.Thiswasthefirstmultinationalandgery;thesituationthathasresultedfromtheinvasivebehaviormulticenteredstudyintermsoftheoncologicresultsofTLMoftumornegativelyaffectsthesurvival(7)..(18)on595patientstreatedwithTLM,therateoffive-yeardisease-specificInthistypeofsurgeries,essfulsurvivalwasreportedas100%inpatientswithT1-%-ancers,thefive-yeardisease-spe-constitutethemostoptimalpatientgroupforthistechnique(8).cificandgeneralsurvivalrateswereapproximately95%andancers,theadditionof“vestibulectomy,”which80%,respectively(19).anpreservation,wasdefinedbyKashimaetal.(9),tothesurgicalprocedureex-andsurvivalrateswerealmostsimilarinRT,TLM,andopenpandstheviewduringsurgeryandalsoallowsbetterfollow-uppartialsurgeries(verticalhemilaryngectomy).(8).ancersaredetectedinlaterstages,andtheirtu-clinicalsuspectinthesefollow-ups,ancers,(20).Supraglotticweredefinedasnewlydevelopedhoarseness,localpainorotalgia,anpreservingsurgerywithaasuspiciousappearanceinthevocalcordinofficelaryngoscopy,five-yearsurvivalrateof70%-75%anddisease-freesurvivalrateorananatomypreventingtheentirevocalcordtobeviewed(8).of90%(21).-ancers,missureinvolvementwasgectomywithTLM,epromi-%(10).monapproachthatisinterna--ofopenpartiallaryngectomyarequitehighinearlyglottictu-essible,whileTLMhassimilarlocalcontrolandsurvivalmissureinvolvement,animportantdis-paredtoopensupraglotticlaryngectomy,itsfunctionalesaremoresatisfying(22,23).Inaddition,,itprovideshighisopened,tumorcannotbeviewed(11).Incontrast,tumoralsoratesoflocalcontrolandsurvival(88%forthreeyears)(23).pletelyviewedinasinglefieldduringTLM,butitisstillremovedwiththemagnificationadvantageofamicro-TheuseofTLMinT1-,-,somestudieshavesuggestedthatasafecientviewofthesurgicalsite,missureinvolvementendoscopicsurgerycanbeperformedwithsomemodificationsinthecraniocaudaldirection(T2),invasionoftheposterior(11-13).Shapshayetal.(12)essfulresultsbyusingparaglotticspacewitharytenoidfixation,massiveinfiltrationofendoscopicandexternalapproachestogetherandincludingathepre-epiglotticspace,andthepresenceofminorthyroidcar-smallpartofthethyroidcartilage,whichencounterswiththetilageerosion(T3)arethemostcontroversialsituationswithre-missure,(24).andlowratesoflocalcontrol,poorqualityofvoiceafterlaserexcisionsinthesetumorslimitsitsadvantageofuse(14).Tay-TheTRSdevice(DaVinciroboticsurgerysystem,Intuitiveloretal.(paredprimarytreatmentapproachesofRTSurgicalInc.,Sunnyvale,CA,USA)-36Topal?.MinimallyInvasiveProceduresforLaryngealCarcinomaTurkArchOtorhinolaryngol2017;55:34-7geonsitsontheconsoleincludingahigh-resolutionthree-di-(%intwoyears).,%.Thisrateissuchassupraglotticlaryngectomy,verticalpartiallaryngectomy,84%inopenpartialsurgeries(36).essrateinTLM,cordectomy,andlaryngectomy,canbeperformedthroughthisinsufficientexperienceinopenpartialsurgeries,andwillingnessparedtoTLM,pleteoncologicsurgerycausetotallaryngec-,instrumentsarticulatedatthedistalendsoftheroboticarmsinanothermeta-analysispublishedin2015,TLMusedintheprovideanadvantageoffreemovementsandhighdegreeoftis-,thetransoralapproachcreatesareportedtoprovidehighratesofsurvival,localcontrol,andor--ganprotection(37).Thedifficultyinthedeterminationofcancerly,patientswithanatomicfeatures,rowth,suchasmulti-arch,anteriorlylocatedlarynx,narrowpharynx,andexistingandfocaldevelopmentandsubmucosalspread,whichcanbeseenincompleteteethareinappropriatecandidatesforTRS(25).recurrenttumorsafterRT,,thesearenolon-InsupraglotticsurgeriesperformedwithTLM,thelesionisgerthedisadvantageswiththeuseoffrozen-sectionbiopsiesinexcisednotasenblock,,,itispossibletoremovetheentiretumoressiveresections(38).Inrecentyears,,al.(26)paredtoopensur--dimension-.(25),particularly,wasmoreadvantageousthanopensurgeriesintermsofwoundtheexcisionofpre-,TRSprovidesthisregiontobesafelyincludedapplicationofaflapintheneckfortheriskoffistulawouldbeinspecimenasenblock(27).Parketal.(27)-yeardisease-freesurvivalaftersupraglotticlaryngec-tomywithTRSas91%,,,whichdays,,areincreas-Ofthetotalpatients,%statedvoiceandswallowingfunc-ingmoreprominentinlaryngealsurgery,.(28)theygiveoncologicallysaferesultsandpreservethelaryngealon13patientswithT1-ancer,,furthermulticenteredpro-ingrestrictivefactors,theadvantagesoftheshortlengthoftransitiontooralfeeding,suchasstilldevelopinginstruments,equipmentandsurgicalshortlengthofhospitalization,,andforcorrectlyinterpretingtheoncologicsafetyInliterature,localcontrolratesafterTRSsupraglotticlaryn-%and100%(29-32).TheroboticapproachisusedasanalternativetoTLMalsoPeer-review:Externallypeer--ancers(33).DisadvantagesoflaryngealConflictofInterest:,highcost,andabsenceofanoptimalretractorforexpandingFinancialDisclosure:Theauthordeclaredthatthisstudyhasreceivedtheworkingsite(27).Moreover,alargeseriesi