Videolaryngoscopic transoral en bloc resection of supraglottic and hypopharyngeal cancers using laparoscopic surgical instruments.
OBJECTIVE
We assessed the outcome of en bloc transoral resection of supraglottic and hypopharyngeal cancer using a distending laryngoscope with rigid videoendoscopic and laparoscopic surgical instruments.


METHODS
We enrolled 30 patients with T1, T2, or selected T3 supraglottic and hypopharyngeal cancer in the study; 9 patients had undergone radiotherapy. Neck dissections were performed for node-positive patients. Postoperative radiotherapy was administered to patients with multiple lymph node metastases or positive surgical margins.


RESULTS
This surgical environment provided a wide view of the operative field, facilitating bimanual manipulation of laparoscopic surgical instruments, and enabled us to perform en bloc transoral resection. In 21 cases with a minimum follow-up period of 1 year (average, 33 months; range, 15 to 56 months), the 3-year disease-specific survival rate and the laryngeal preservation rate were each 95%. Normal food intake was eventually possible in all cases. Tracheostomy was performed for 2 patients as a prophylactic measure and for 1 patient because of a postoperative hemorrhage.


CONCLUSIONS
These results indicate that videolaryngoscopic transoral en bloc resection using laparoscopic surgical instruments can be one of the minimally invasive treatment options for supraglottic and hypopharyngeal cancers with satisfactory oncological outcome and postoperative laryngeal function.
Shiotani
Akihiro
A
Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
Tomifuji
Masayuki
M
Araki
Koji
K
Yamashita
Taku
T
Saito
Koichiro
K
D003680:Deglutition Disorders / Q000209:etiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D020706:Laparoscopes; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007828:Laryngoscopy / Q000379:methods*; D011183:Postoperative Complications; D014139:Tracheostomy; D016896:Treatment Outcome; D020535:Video-Assisted Surgery / Q000379:methods*