Robot-assisted surgery for upper aerodigestive tract neoplasms.
OBJECTIVE
To assess the feasibility and safety of performing robot-assisted resections of head and neck tumors, and to predict which variables lead to successful robot-assisted resection and better functional outcome.


METHODS
Prospective nonrandomized clinical trial.


METHODS
Academic tertiary referral center.


METHODS
Thirty-six patients with oral cavity, oropharyngeal, hypopharyngeal, or laryngeal tumors.


METHODS
Robot-assisted resection of indicated tumors.


METHODS
Ability to perform robot-assisted resection, final pathologic margin status, ability to extubate postoperatively, need for tracheotomy tube, and need for gastrostomy tube. Any clinically significant complications were recorded.


RESULTS
Thirty-six patients participated in the study. Eight patients had previously been treated for head and neck cancer. Twenty-nine patients (81%) underwent successful robotic resection. Negative margins were obtained in all 29 patients. Twenty-one of 29 patients were safely extubated prior to leaving the operating room. One patient required short-term tracheotomy tube placement. A total of 9 patients were gastrostomy tube dependent (2 preoperatively, 7 postoperatively). Factors associated with successful robotic resection were lower T classification (P = .01) and edentulism (P = .07). Factors associated with gastrostomy tube dependence were advanced age (P = .02), tumor location in the larynx (P < .001), higher T classification (P = .02), and lower preoperative M. D. Anderson Dysphagia Inventory score (P = .04).


CONCLUSIONS
Robot-assisted surgery is feasible and safe for the resection of select head and neck tumors. This clinical series demonstrates that robotic surgery can be utilized successfully in patients with T1 to T4 lesions located in the oral cavity, oropharynx, hypopharynx, and larynx with good preservation of swallow function.
Boudreaux
Bridget A
BA
Division of Otolaryngology, BDB 563, 1530 Third Ave S, Birmingham, AL 35294-0012, USA.
Rosenthal
Eben L
EL
Magnuson
J Scott
JS
Newman
J Robert
JR
Desmond
Reneé A
RA
Clemons
Lisa
L
Carroll
William R
WR
D000367:Age Factors; D016063:Blood Loss, Surgical; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D005260:Female; D005774:Gastrostomy; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007575:Jaw, Edentulous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011183:Postoperative Complications; D011446:Prospective Studies; D012371:Robotics