OP191: Robot-assisted modified radical neck dissection via a retroauricular or modified face lift approach in clinically N+ head and neck cancer: A comparative study with the conventional transcervical neck dissection

Abstract

Purpose In our feasibility study of robot-assisted neck dissection (RAND), we limited the indication for elective neck dissection (ND) in clinical N0 head and neck cancer. With growing experiences of RAND, we saw potential for therapeutic RAND in positive neck without extracapsular spread (ECS). In this study, we aim to compare the results of therapeutic RAND via a retroauricular (RA) or modified face-lift (MFL) approach with conventional transcervical ND in head and neck cancer. Materials and methods This study involved a total of 53 patients who underwent therapeutic ND for head and neck cancer at the department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea, from May 2010 to July 2012. Patients themselves decided whether the RAND or the conventional open ND would be performed for the treatment of neck metastasis with the information of the advantages and the disadvantages of both procedures. The following variables were assessed: age, gender, body mass index, primary site, TNM stage, operative parameters, pathologic parameters, perioperative complications, and satisfaction of scar. Results The RAND group consisted of 17 males and three females, with a median age of 62.5 years. The conventional ND group consisted of 30 males and three females, with a median age of 63.0 years. The mean operation time for ND of the RAND group was longer than that of the conventional ND group (186 ± 37 vs 150 ± 23) (p = 0.000). The mean number of retrieved lymph nodes in the RAND group (41.60 ± 12.47) showed no significant difference from that in the conventional ND group (44.39 ± 14.35) (p = 0.474). There were no significant differences in the development of postoperative complications between the RAND group and the conventional ND group. The score of satisfaction scar was significantly higher in the RAND group than in the conventional ND group (p = 0.023). The median follow-up periods were 8.0 month in the RAND group and 9.3 month in the conventional ND group. Conclusions Therapeutic RAND via a RA or MFL approach was feasible and successful, with satisfactory aesthetic results in patients with N+ head and neck cancer. This RAND technique via a RA or MFL approach may be applied to the selected cases by an experienced surgeon.