Transoral Robotic Surgery for Hypopharyngeal Carcinoma

Abstract

Objective: Conventional surgical approaches for hypopharyngeal carcinomas have a great risk for developing treatment-related morbidity. To minimize this morbidity, hypopharyngectomy by transoral robotic surgery (TORS) was performed, and the efficacy and feasibility of this procedure were evaluated. Method: TORS was performed using Surgical Robot in 18 patients with T1 or T2 pyriform sinus cancer. Pyriform sinus was totally resected. Laterally, the inner perichondrium of the thyroid cartilage was peeled off to make sure of the safe margin. We evaluated the surgical margins, swallowing, decannulation, and surgery related complications. Results: Transoral robotic hypopharyngectomy was performed successfully in all eighteen patients. The mean robotic operation time was 62.4 minutes, and an average of 17.5 minutes was required for the setting of the robotic system. There was no significant perioperative complication in the cases. Swallowing function returned to all patients within 8.3 days average. Decannulation was carried out within an average of 6.3 days after surgery. We can confirm the negative margins by frozen section. Average surgical margins are 7.5mm circumferentially. Conclusion: Transoral robotic hypopharyngectomy is a feasible and oncologically safe technique for the treatment of early hypopharyngeal cancer.