Retropharyngeal lymph node metastases from head and neck cancer removed by transoral robotic surgery
10.3760/cma.j.cn115330-20240812-00471
- VernacularTitle:经口机器人手术切除头颈癌咽后转移淋巴结的初步尝试
- Author:
Ming SONG
1
;
Ping HAN
;
Shuwei CHEN
;
Faya LIANG
;
Ankui YANG
;
Quan ZHANG
;
Peiliang LIN
;
Xiaoming HUANG
Author Information
1. 中山大学肿瘤防治中心头颈科 华南恶性肿瘤防治全国重点实验室 广东省恶性肿瘤临床医学研究中心，广州 510060
- Publication Type:Journal Article
- Keywords:
Head and neck neoplasms;
Retropharyngeal lymph node;
Lymph node dissection;
Transoral robotic surgery
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2025;60(3):292-299
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety, and feasibility of transoral robot-assisted retropharyngeal lymph node (RPLN) dissection.Methods:Clinical data of head and neck cancer patients who underwent transoral robot-assisted RPLN dissection at the Department of Otorhinolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, and Sun Yat-sen University Cancer Centre from December 2017 to March 2024 were retrospectively analyzed. A total of 35 patients(22 males, 13 females, aged 47.4±13.4 years old) with RPLN metastases from head and neck cancer, including 20 cases of nasopharyngeal cancer, 9 cases of thyroid cancer, 2 cases of salivary adenocarcinoma, 2 cases of tonsil cancer, and 2 cases of hypopharyngeal cancer. Operation time, intraoperative bleeding and complications, postoperative nasogastric tube retention time, hospital stay and complications were evaluated. Statistical analysis was performed using SPSS 22.0 software.Results:All patients successfully received transoral robot-assisted RPLN dissection without intermediate open surgery, with removals of 2 (1, 3) RPLNs. The total operation time was 130 (102, 210) minutes. The intraoperative bleeding was 50 (20, 100) ml, and there was no major bleeding or organ damage during the operation. Prophylactic tracheotomy was performed in 8 cases, and postoperatively nasogastric tubes were left in 22 patients, with retention time of 10.5 (7.5, 14.0) days. Postoperative hospital stay was 5 (4, 9) days. Postoperative complications included incision dehiscence in 4 cases and dysphagia in 4 cases. The median postoperative follow-up was 23.4 months, with progression or recurrence in 5 patients, including regional recurrence in 3 patients, lung metastasis in 1 patient, and bone metastasis in 1 patient. The 2-year regional failure-free survival and disease-free survival rates were 91.43% and 85.71%, respectively.Conclusion:Transoral robot-assisted RPLN dissection is a safe and feasible surgical method with less trauma, fewer complications, and higher safety. Patients need to be carefully selected at the initial stage of application.
