Pull-through resection without free-flap reconstruction for lateral wall oropharyngeal cancer

2020 ◽  
Vol 50 (9) ◽  
pp. 1018-1022
Author(s):  
Fumihiko Matsumoto ◽  
Kenya Kobayashi ◽  
Go Omura ◽  
Satoko Matsumura ◽  
Yoshifumi Matsumoto ◽  
...  

Abstract Background While transoral robotic surgery (TORS) is widely used for the management of lateral wall oropharyngeal carcinomas (OPC), open surgical techniques are still used in some cases. A pull-through method for open surgical resections of OPC has recently been introduced. We improved on this method by eliminating the need for subsequent free-flap reconstruction. Methods 16 patients with lateral wall OPC underwent pull-through resections. After resection, we used the digastric muscle, stylohyoid muscles, submandibular gland and the surrounding tissues to block the neck and oral cavity and to avoid reconstruction. Results This novel technique was performed without major complications or morbidities. The average post-operative hospital stay was 14.6 ± 6.1 days, and the average duration until initiation of oral intake post-operation was 6.5 ± 2.9 days. Oncological outcomes, post-operative course and function were acceptable. Conclusions Our novel method provides an efficient and less invasive surgical technique than conventional open approaches.

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Samer Al-khudari ◽  
Scott Bendix ◽  
Jamie Lindholm ◽  
Erin Simmerman ◽  
Francis Hall ◽  
...  

Objective. To evaluate factors that influence gastrostomy tube (g-tube) use after transoral robotic surgery (TORS) for oropharyngeal (OP) cancer. Study Design/Methods. Retrospective review of TORS patients with OP cancer. G-tube presence was recorded before and after surgery at followup. Kaplan-Meier and Cox hazards model evaluated effects of early (T1 and T2) and advanced (T3, T4) disease, adjuvant therapy, and free flap reconstruction on g-tube use. Results. Sixteen patients had tonsillar cancer and 13 tongue base cancer. Of 22 patients who underwent TORS as primary therapy, 17 had T1 T2 stage and five T3 T4 stage. Seven underwent salvage therapy (four T1 T2 and three T3 T4). Nine underwent robotic-assisted inset free flap reconstruction. Seventeen received adjuvant therapy. Four groups were compared: primary early disease (PED) T1 and T2 tumors, primary early disease with adjunctive therapy (PEDAT), primary advanced disease (PAD) T3 and T4 tumors, and salvage therapy. Within the first year of treatment, 0% PED, 44% PEDAT, 40% PAD, and 57% salvage patients required a g-tube. Fourteen patients had a temporary nasoenteric tube (48.3%) postoperatively, and 10 required a g-tube (34.5%) within the first year. Four of 22 (18.2%) with TORS as primary treatment were g-tube dependent at one year and had received adjuvant therapy. Conclusion. PED can be managed without a g-tube after TORS. Similar feeding tube rates were found for PEDAT and PAD patients. Salvage patients have a high rate of g-tube need after TORS.


2019 ◽  
Author(s):  
Ramez Philips ◽  
Alexander Graf ◽  
Michael Topf ◽  
Howard Krein ◽  
Ryan Heffelfinger ◽  
...  

2021 ◽  
Author(s):  
Brian Swendseid ◽  
Matthew Stewart ◽  
Eric Mastrolonardo ◽  
Eleanor McCreary ◽  
Ryan Heffelfinger ◽  
...  

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