title: Endoscopic transoral oropharyngectomy using laparoscopic surgical instruments.
abstract: BACKGROUND
  Recently, several transoral approaches for minimally invasive surgery have been developed for oropharyngeal cancer. However, all approaches have certain disadvantages. Therefore, we built and examined new surgical environments for improving the situation.
  
  
  METHODS
  Endoscopic transoral resection using a pharyngeal retractor or distending laryngoscope, rigid videoendoscope, and laparoscopic surgical instruments was performed in 17 patients with oropharyngeal squamous cell carcinoma. Postoperative results regarding oncology and function as well as complications were documented.
  
  
  RESULTS
  The 2-year relapse-free survival rate was 100%. Postoperative swallowing and speech function were satisfactory: 94.1% of cases scored ≤1 on the functional outcome swallowing scale (FOSS) and ≤1 on the communication score. Further, no perioperative mortality occurred.
  
  
  CONCLUSIONS
  The improved surgical environment made it possible to perform a safe and reliable en bloc resection with a wide field of view and sufficient working space. Our system can be useful, although further studies on additional cases are required.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Yamashita
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tomifuji
authors.forename: Koji
authors.initials: K
authors.lastname: Araki
authors.forename: Takaomi
authors.initials: T
authors.lastname: Kurioka
authors.forename: Akihiro
authors.initials: A
authors.lastname: Shiotani
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D003679:Deglutition; D004724:Endoscopy; D005260:Female; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy; D020704:Laryngoscopes; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000628:therapy*; D009960:Oropharynx / Q000601:surgery*; D010611:Pharyngectomy / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications; D013060:Speech; D020535:Video-Assisted Surgery / Q000295:instrumentation