title: Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery.
abstract: BACKGROUND
  Transoral laser microsurgery (TLM) is a mature approach to supraglottic cancer, while transoral robotic surgery (TORS) is emerging. The present study compared these approaches.
  
  
  METHODS
  The first 10 patients (2002-2005) given TLM were compared with the first 10 (2007-2011) given TORS for cT1-3 cN0-cN2c supraglottic cancer.
  
  
  RESULTS
  A feeding tube was used in four TLM and seven TORS patients. Margins were more often positive, but operating times shorter, in TORS. All 10 TORS patients are without evidence of disease, but only six TLM patients remain disease-free after much longer follow-up. TORS was considerably less uncomfortable and fatiguing for the surgeon.
  
  
  CONCLUSIONS
  TORS seems as safe and effective as TLM. Shorter TORS operating times are probably attributable to prior experience with TLM. For laryngeal exposure, length of tube placement and margin evaluability, TLM was superior; however, this may change as TORS develops and transoral robotic instruments are optimized.
authors.affiliation: Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
authors.forename: Mohssen
authors.initials: M
authors.lastname: Ansarin
authors.forename: Stefano
authors.initials: S
authors.lastname: Zorzi
authors.forename: Maria Angela
authors.initials: MA
authors.lastname: Massaro
authors.forename: Marta
authors.initials: M
authors.lastname: Tagliabue
authors.forename: Michele
authors.initials: M
authors.lastname: Proh
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Giugliano
authors.forename: Luca
authors.initials: L
authors.lastname: Calabrese
authors.forename: Fausto
authors.initials: F
authors.lastname: Chiesa
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D053685:Laser Therapy / Q000379:methods; D007834:Lasers; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010865:Pilot Projects; D012189:Retrospective Studies; D012371:Robotics; D059525:Supraglottitis / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D016896:Treatment Outcome
keywords: supraglottic cancer; transoral laser microsurgery; transoral robotic surgery