经口机器人手术治疗声门上型喉癌的多中心回顾性研究  

Multicenter retrospective study of transoral robotic surgery for supraglottic laryngeal cancer

作　　者：徐凯[1] 陶磊 王琰[3] 梁发雅[4] 徐成志 邓岚岚 邹鑫 陆翔 黄晓明[4] 韩萍[4] Xu Kai;Tao Lei;Wang Yan;Liang Faya;Xu Chengzhi;Deng Lanlan;Zou Xin;Lu Xiang;Huang Xiaoming;Han Ping(Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430030,China;Department of Otolaryngology Head and Neck Surgery,Eye&ENT Hospital,Fudan University,Shanghai 200031,China;Department of Otorhinolarygology,The First Affiliated Hospital of China Medical University,Shenyang 110001,China;Department of Otorhinolaryngology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Key Laboratory of Epigenetics and Gene Regulation of Malignant Tumor in Guangdong Province,Guangzhou 510280,China)

机构地区：[1]华中科技大学同济医学院附属同济医院耳鼻咽喉头颈外科,武汉430030 [2]复旦大学附属眼耳鼻喉科医院耳鼻咽喉头颈外科,上海200031 [3]中国医科大学附属第一医院耳鼻咽喉科,沈阳110001 [4]中山大学孙逸仙纪念医院耳鼻咽喉科、广东省恶性肿瘤表观遗传学与基因调控重点实验室,广州510280

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第3期266-271,共6页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：广州地区临床重大技术项目(2023P-ZD13)。

摘　　要：目的初步探讨经口机器人手术(TORS)治疗声门上型喉癌的安全有效性及近期疗效。方法回顾性分析2018年1月至2024年4月中山大学孙逸仙纪念医院、华中科技大学同济医学院附属同济医院、复旦大学附属眼耳鼻喉科医院及中国医科大学附属第一医院采用TORS治疗声门上型喉癌的患者资料,分析手术时间、术中出血量、术后住院天数、围手术期气管切开情况、鼻饲饮食、并发症及近期随访情况。使用Python进行统计学分析。结果4个中心共纳入27例声门上型喉癌患者,其中男性24例,女性3例,年龄66(65,68)岁[M(Q_(1),Q_(3)),下同]。包括鳞状细胞癌26例,腺样囊性癌1例;T1期10例(37.04%),T2期13例(48.15%),T3期4例(14.81%);N0期14例(51.85%),N1期7例(25.93%),N2期6例(22.22%)。采用达芬奇Si 23例,达芬奇Xi 4例,机器人手术时间为53(30,58)min,同期行颈淋巴清扫25例,术前新辅助治疗8例(29.63%),术后放疗13例(48.15%)。气管切开11例(40.74%),留置胃管23例(85.19%),留置胃管时间为16(12,21)d,术后住院时长为(9.19±4.07)d;随访时间12(3,30)个月。2例出现局部复发,3年生存率为100%,3年无病生存率为94.1%。结论在适应证选择合理的前提下,应用TORS治疗声门上型喉癌近期疗效满意,具有安全、有效、微创的优点,可作为治疗新选择。ObjectiveTo explore the safety,effectiveness,and short-term outcomes of transoral robotic surgery(TORS)for supraglottic laryngeal cancer.MethodsA retrospective analysis was conducted on patients with supraglottic laryngeal cancer who underwent TORS at Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology,Eye Ear Nose and Throat Hospital of Fudan University,and the First Affiliated Hospital of China Medical University between January 2018 and April 2024.Data on operative time,intraoperative blood loss,postoperative hospital stay,perioperative tracheostomy,nasogastric feeding,complications,and short-term follow-up were analyzed.Statistical analysis was performed using Python.ResultsA total of 27 patients with supraglottic laryngeal cancer were included from the four centers,including 24 males and 3 females,with a median age of 66(65,68)years[M(Q_(1),Q_(3)),same below].There were 26 cases of squamous cell carcinoma and 1 case of adenoid cystic carcinoma.The TNM staging included T1 in 10 cases(37.04%),T2 in 13 cases(48.15%),and T3 in 4 cases(14.81%);N0 in 14 cases(51.85%),N1 in 7 cases(25.93%),and N2 in 6 cases(22.22%).The Da Vinci Si system was used in 23 cases,and the Da Vinci Xi in 4 cases.The robotic surgical time was 53(30,58)min.Concurrent neck dissection was performed in 25 cases,neoadjuvant therapy was given preoperatively in 8 cases(29.63%),and postoperative radiotherapy was administered in 13 cases(48.15%).Tracheostomy was performed in 11 cases(40.74%).Nasogastric tube placement was required in 23 cases(85.19%),with a median duration of 16(12,21)days.The postoperative hospital stay was 9.19±4.07 days.The median follow-up time was 12(3,30)months.Local recurrence occurred in 2 cases.The 3-year overall survival rate was 100%,and the 3-year disease-free survival rate was 94.1%.ConclusionWith appropriate patient selection,TORS for supraglottic laryngeal cancer demonstrates satisfactory short-term outcomes,thereby offeri

关 键 词：头颈部肿瘤 声门上型喉癌 经口机器人手术 微创 

分 类 号：R739.65[医药卫生—肿瘤]