经口机器人手术治疗下咽癌的初步经验  

Preliminary experience and outcomes of transoral robotic surgery for hypopharyngeal cancer

作　　者：韩萍[1] 黄晓明[1] 徐成志 陶磊 杨会军[3] 楚龙娟 刘银豪 徐凯[4] 陆翔 Han Ping;Huang Xiaoming;Xu Chengzhi;Tao Lei;Yang Huijun;Chu Longjuan;Liu Yinhao;Xu Kai;Lu Xiang(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;Department of Otolaryngology Head and Neck Surgery,Eye&ENT Hospital of Fudan University,Shanghai 200031,China;Department of Otorhinolarygology,First Affiliated Hospital of China Medical University,Shenyang 110001,China;Department of Otorhinolaryngology Head and Neck Surgery,Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science&Technology,Wuhan 430030,China)

机构地区：[1]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与基因调控重点实验室,广州510280 [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]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

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第3期272-277,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：目的总结经口机器人手术(TORS)治疗下咽癌的临床经验及预后。方法分析2017年9月至2024年3月华中科技大学同济医学院附属同济医院、中山大学孙逸仙纪念医院和复旦大学附属眼耳鼻喉科医院应用达芬奇机器人系统手术完成的28例下咽癌患者的临床资料,均为男性,年龄47~82(62.5±7.1)岁。依据第八版美国癌症联合委员会(AJCC)分期,T1期6例,T2期17例,T3期3例,T4期2例;N0期18例,N1期3例,N2期6例,N3期1例。通过SPSS 26软件绘制Kaplan-Meier生存曲线,计算总体生存率、无瘤生存率等。结果28例患者均顺利完成手术,无中转开放,无阳性切缘病例。术后1个月内2例患者死亡。2例患者口腔少量出血,均经保守治疗出血停止。术后随访1~81个月,中位随访时间24.8个月,5例患者(17.9%)死亡,5例(17.9%)局部复发,4例(14.3%)出现远处转移。术后3年总体生存率为77.1%,局部控制率为74.6%,无瘤生存率为57.1%。结论在适应证选择合理的前提下,TORS切除下咽癌具有较好的生存率和局部控制率,可作为下咽癌手术治疗的新选择。ObjectiveTo summarize preliminary experience and outcomes of transoral robotic surgery(TORS)in hypopharyngeal cancer.MethodsClinical data of 28 patients with hypopharyngeal cancer underwent TORS with Da Vinci Si or Xi surgical system in three medical centers(Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University and Eye&ENT Hospital of Fudan University)in China from Sep 2017 to Mar 2024 were respectively analyzed.All patients were males,aged from 47 to 82(62.5±7.1)years old.According to TNM staging of AJCC,the stages included T1 in 6 cases,T2 in 17 cases,T3 in 3 cases and T4 in 2 cases;N0 in 18 cases,N1 in 3 cases,N2 in 6 cases,N3 in 1 case.SPSS version 26 was applied,and with Kaplan-Meier surviving curves,overall survival,local control rate and disease-free survival for those patients were calculated.ResultsAll 28 patients underwent successfully their TORS,no any case with transfer opening or positive surgical margin.Two patients died within one month after surgery.Two patients experienced minor oral bleeding,and subsenquently was cured.The follow-up period ranged from 1 to 81 months,with an average of 24.8 months,in which,five patients(17.9%)died,five patients(17.9%)experienced local recurrence and four patients(14.3%)had distant metastases.The three year overall survival,local control rate and disease-free survival were 77.1%,74.6%and 57.1%,respectively.ConclusionIn properly selected cases of hypopharyngeal cancer,TORS can offer acceptable survival and local control rates,which can be considered as a new useful option for the surgery of hypopharyngeal cancer.

关 键 词：头颈部肿瘤 下咽癌 经口机器人手术 微创外科 

分 类 号：R739.63[医药卫生—肿瘤]