title: Feasibility of robot-assisted neck dissection followed by transoral robotic surgery.
abstract: Our aim was to evaluate the feasibility of robot-assisted neck dissection (RAND) followed by transoral robotic surgery (TORS) in treatment of cancers of the head and neck, which is expected to improve cosmesis and function. We studied 37 patients with biopsy-confirmed cNO or cN+ tumours of the oropharynx (n=22), hypopharynx (n=8), larynx (n=6), and oral cavity (n=1) who were treated by RAND then TORS from May 2010 to December 2012. Patients' characteristics and clinical details were recorded, together with operative complications and functional variables such as management of the airway and nasogastric or enterogastric feeding. All endoscopic TORS and RAND were successful, with no serious intraoperative complications or need to convert to open operation. All patients were satisfied with the cosmesis according to the answers given to a questionnaire. RAND followed by TORS in some cancers of the head and neck are feasible and showed a clear cosmetic benefit, although the longer operating time is a drawback. Studies of more patients with longer follow-up are required to evaluate long-term oncological and functional outcomes in more detail.
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: H K
authors.initials: HK
authors.lastname: Byeon
authors.affiliation: Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Stanford, CA, USA.
authors.forename: F C
authors.initials: FC
authors.lastname: Holsinger
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Soonchunhyang University College of Medicine, Seoul, Republic of Korea.
authors.forename: J W
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Soonchunhyang University Cheonan Hospital, Cheonan, Republic of Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ywkohent@yuhs.ac.
authors.forename: Y W
authors.initials: YW
authors.lastname: Koh
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: E C
authors.initials: EC
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058109:Airway Management / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004724:Endoscopy / Q000379:methods; D004954:Esthetics; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery; D007431:Intraoperative Complications; D007441:Intubation, Gastrointestinal / Q000379:methods; D007822:Laryngeal Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009055:Mouth / Q000601:surgery*; D009062:Mouth Neoplasms / Q000601:surgery; D037981:Neck Dissection / Q000379:methods*; D061646:Operative Time; D009959:Oropharyngeal Neoplasms / Q000601:surgery; D017060:Patient Satisfaction; D065287:Robotic Surgical Procedures / Q000379:methods*; D014140:Tracheotomy / Q000379:methods; D016896:Treatment Outcome
keywords: Head and neck cancer; Minimally invasive surgery; Remote access; Robot-assisted neck dissection; Transoral robotic surgery