单孔机器人经口咽喉部良性肿物手术治疗  

Single-port transoral robotic surgery for laryngeal and pharyngeal benign lesions

作　　者：沈怡琳 叶斌 吴继昌[1] 胡海霞 范翠 施知泓 秦济栋 向明亮 Shen Yilin;Ye Bin;Wu Jichang;Hu Haixia;Fan Cui;Shi Zhihong;Qin Jidong;Xiang Mingliang(Department of Otolaryngology&Head and Neck Surgery,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200070,China;Department of Otorhinolaryngology,Head and Neck Surgery,Hainan Hospital of Ruijin Hospital(Boao Research Hospital of Hainan),Hainan 460000,China)

机构地区：[1]上海交通大学医学院附属瑞金医院耳鼻咽喉头颈外科,上海200070 [2]上海交通大学医学院附属瑞金医院海南医院(海南博鳌研究型医院),海南460000

出　　处：《中华耳鼻咽喉头颈外科杂志》2025年第3期345-349,共5页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金重大研究计划(91949119)。

摘　　要：目的总结并提供单孔机器人经口咽喉部良性肿物手术经验。方法分析上海交通大学医学院附属瑞金医院海南医院(海南博鳌研究型医院)2023年8月1日至2024年4月10日,采用单孔机器人经口手术治疗的3例咽喉良性肿物患者资料,男性1例,女性2例,平均年龄56.3岁。包括会厌囊肿1例、杓会厌襞囊肿1例,舌根型甲状舌管囊肿1例。分析术中中转率、术中出血量、手术时间、住院时间、疼痛评分及吞咽功能评分等指标。结果患者均顺利完成手术,肿物均完整切除,无中转开放。术中出血量0~7 ml,中位出血量3.0 ml;自首次暴露满意至完成手术时间为5~30 min,中位手术时间7.0 min;无门牙松动脱落、咽侧壁软组织擦伤等不良事件发生。患者术后24 h均恢复经口进食,无进食呛咳、术后出血、术后呼吸困难等发生;平均住院天数为3.7 d。术后第3天疼痛VAS评分较术后第1天降低,术后1个月吞咽功能恢复良好。结论单孔机器人经口咽喉部良性肿物切除术安全、高效,并发症少。ObjectiveTo share our experience of single-port transoral Da Vinci robotic surgery for laryngeal and pharyngeal benign tumors.MethodsThree patients aged over 18 years and diagnosed respectively with epiglottic cyst,aryepiglottic fold cyst and thyroglossal duct cyst at tongue base were included who received operations in Hainan Hospital of Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine(Boao Research Hospital of Hainan)between August 1,2023 and April 10,2024.There were 1 male and 2 females,with an average age of 59 years old.The clinical diagnosis of these 3 patients was respectively epiglottic cyst,aryepiglottic fold cyst and thyroglossal duct cyst at tongue base.Intraoperative conversion rate,blood loss,operation time,hospital stay,pain score and swallowing function score were analyzed.ResultsAll three patients successfully underwent the operations with the single-port Da Vinci robotic system.The clean-contaminated resection rate of the tumors was 100%.The conversion rate was nil.The blood loss was 0-7 ml.The operation time was 5-30 minutes.There were no adverse events such as loosening of teeth and soft tissue abrasions of pharyngeal side wall.The rate of oral feeding within 24 hours after surgery was 100%.No postoperative coughing,bleeding,or dyspnea occurred.The average length of hospital stay was 3.7 days.The VAS score decreased 3 days after surgery compared to 1 day after surgery.The swallowing function recovered 1 month after surgery.ConclusionThe single-port transoral robotic surgery for laryngeal and pharyngeal benign lesions is safe and efficient,with fewer complications.

关 键 词：外科手术 微创性 达·芬奇机器人手术系统 单孔机器人手术 经口机器人手术 耳鼻咽喉科学 

分 类 号：R739.6[医药卫生—肿瘤]