N Möckelmann1, C-J Busch2, A Münscher2, R Knecht3, B B Lörincz2. 1. Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Centre Hamburg-Eppendorf, Head and Neck Cancer Centre of the University Cancer Centre Hamburg (UCCH), Martinistr. 52, D-20246 Hamburg, Germany. Electronic address: n.moeckelmann@uke.de. 2. Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Centre Hamburg-Eppendorf, Head and Neck Cancer Centre of the University Cancer Centre Hamburg (UCCH), Martinistr. 52, D-20246 Hamburg, Germany. 3. Department of Otorhinolaryngology, Head & Neck Surgery and Oncology, University Medical Centre Hamburg-Eppendorf, Head and Neck Cancer Centre of the University Cancer Centre Hamburg (UCCH), Martinistr. 52, D-20246 Hamburg, Germany. Electronic address: r.knecht@uke.de.
Abstract
BACKGROUND: Oncologic transoral robotic surgery (TORS) requires in most cases the concurrent or staged surgical treatment of the regional lymph nodes in the neck as well. The purpose of this study was to determine whether the timing of the regional lymphadenectomy (neck dissection) has an impact on the surgical outcomes and on the complication rates. METHODS: Single-institution, prospective case series with internal control group. Twenty-one patients underwent TORS and appropriate neck dissection concurrently (control group), while 20 patients underwent neck dissection in a timely staged fashion, 8.4 days (median; range, 3-28 days) following their TORS procedure (experimental group). Outcome measures included nodal yield, intraoperative pharyngocervical fistula formation, postoperative fistula formation, postoperative bleeding from the primary and from the neck dissection site, haematoma, seroma, and infection. RESULTS: Nodal yield values, as the oncologic quality indicator of a neck dissection, were comparable in the experimental and in the control group. Complication rates did not differ between the groups: intraoperative and postoperative fistula formation, postoperative bleeding, haematoma and seroma rates were similarly low in the two groups. There was no infection in either group. CONCLUSIONS: In the present cohort of 41 TORS-patients, the timing of neck dissection did not make a significant difference in the outcomes. We suggest therefore that aspiring and established TORS-teams do not restrict their appropriate indications due to robotic slot and theatre time constraints, but perform each indicated TORS-case as soon as possible within their given systems, even if the neck dissections cannot be done on the same day.
BACKGROUND: Oncologic transoral robotic surgery (TORS) requires in most cases the concurrent or staged surgical treatment of the regional lymph nodes in the neck as well. The purpose of this study was to determine whether the timing of the regional lymphadenectomy (neck dissection) has an impact on the surgical outcomes and on the complication rates. METHODS: Single-institution, prospective case series with internal control group. Twenty-one patients underwent TORS and appropriate neck dissection concurrently (control group), while 20 patients underwent neck dissection in a timely staged fashion, 8.4 days (median; range, 3-28 days) following their TORS procedure (experimental group). Outcome measures included nodal yield, intraoperative pharyngocervical fistula formation, postoperative fistula formation, postoperative bleeding from the primary and from the neck dissection site, haematoma, seroma, and infection. RESULTS: Nodal yield values, as the oncologic quality indicator of a neck dissection, were comparable in the experimental and in the control group. Complication rates did not differ between the groups: intraoperative and postoperative fistula formation, postoperative bleeding, haematoma and seroma rates were similarly low in the two groups. There was no infection in either group. CONCLUSIONS: In the present cohort of 41 TORS-patients, the timing of neck dissection did not make a significant difference in the outcomes. We suggest therefore that aspiring and established TORS-teams do not restrict their appropriate indications due to robotic slot and theatre time constraints, but perform each indicated TORS-case as soon as possible within their given systems, even if the neck dissections cannot be done on the same day.
Authors: Arne Böttcher; Heidi Olze; Nadine Thieme; Carmen Stromberger; Steffen Sander; Adrian Münscher; Johannes Bier; Steffen Knopke Journal: J Cancer Res Clin Oncol Date: 2017-04-10 Impact factor: 4.553
Authors: Jai Parkash Ramchandani; Aina Brunet; Nikoleta Skalidi; Jack Faulkner; Aleix Rovira; Ricard Simo; Jean-Pierre Jeannon; Asit Arora Journal: OTO Open Date: 2022-10-11
Authors: Arne Böttcher; Christian S Betz; Stefan Bartels; Bjoern Schoennagel; Adrian Münscher; Lara Bußmann; Chia-Jung Busch; Steffen Knopke; Eric Bibiza; Nikolaus Möckelmann Journal: J Cancer Res Clin Oncol Date: 2020-08-18 Impact factor: 4.553