Videolaryngoscopic transoral en bloc resection of supraglottic and hypopharyngeal cancers using laparoscopic surgical instruments.

Abstract

OBJECTIVES:

We assessed the outcome of en bloc transoral resection of supraglottic and hypopharyngeal cancer using a distending laryngoscope with rigid videoendoscopic and laparoscopic surgical instruments.

METHODS:

We enrolled 30 patients with T1, T2, or selected T3 supraglottic and hypopharyngeal cancer in the study; 9 patients had undergone radiotherapy. Neck dissections were performed for node-positive patients. Postoperative radiotherapy was administered to patients with multiple lymph node metastases or positive surgical margins.

RESULTS:

This surgical environment provided a wide view of the operative field, facilitating bimanual manipulation of laparoscopic surgical instruments, and enabled us to perform en bloc transoral resection. In 21 cases with a minimum follow-up period of 1 year (average, 33 months; range, 15 to 56 months), the 3-year disease-specific survival rate and the laryngeal preservation rate were each 95%. Normal food intake was eventually possible in all cases. Tracheostomy was performed for 2 patients as a prophylactic measure and for 1 patient because of a postoperative hemorrhage.

CONCLUSIONS:

These results indicate that videolaryngoscopic transoral en bloc resection using laparoscopic surgical instruments can be one of the minimally invasive treatment options for supraglottic and hypopharyngeal cancers with satisfactory oncological outcome and postoperative laryngeal function.

• Authors: Akihiro Shiotani, Masayuki Tomifuji, Koji Araki, Taku Yamashita, Koichiro Saito
• Journal: The Annals of otology, rhinology, and laryngology (Ann Otol Rhinol Laryngol) Vol. 119 Issue 4 Pg. 225-32 (Apr 2010) ISSN: 0003-4894 [Print] United States
• PMID: 20433020 (Publication Type: Journal Article)

Topics

• Deglutition Disorders (etiology)
• Humans
• Hypopharyngeal Neoplasms (mortality, surgery)
• Laparoscopes
• Laryngeal Neoplasms (mortality, surgery)
• Laryngoscopy (methods)
• Postoperative Complications
• Tracheostomy
• Treatment Outcome
• Video-Assisted Surgery (methods)