口鼻联合入路机器人辅助下手术切除局限性复发鼻咽癌:初步尝试

Robotic nasopharyngectomy via combined approach of nose and oral for local recurrent nasopharyngeal carcinoma

目的:手术是复发鼻咽癌挽救性治疗方式之一。本研究初步探讨达芬奇机器人手术用于一程放疗后的复发鼻咽癌手术的安全性及有效性。方法:自2017-10起,使用Da Vinci手术机器人完成局部复发鼻咽癌手术,包括经口-软腭裂开及导尿管悬吊软腭经口鼻联合入路两种手术方式。结果:10例患者接受机器人鼻咽部切除术,手术过程顺利,中位手术时间为90min,中位随访时间为6个月,切缘均为阴性,短期随访无局部复发、远处转移及肿瘤相关患者死亡。结论:经口鼻联合入路机器人辅助下手术切除局限性复发鼻咽癌具有安全性、有效性及较好的局部控制率。

Objective：Surgery is one of the salvage treatments for recurrent nasopharyngeal carcinoma.The safety and efficacy of Da Vinci＇s robotic surgery was preliminarily investigated to resect recurrent nasopharyngeal cancer after one-course radiotherapy.Method：Since Oct 2017,Da Vinci surgery system was used to complete the operation of locally recurrent nasopharyngeal carcinoma including two approaches,such as trans oral with soft palate incision and trans oral and nose with soft palate suspended.Result：Ten patients underwent robotic nasopharyngectomy,The median operation time was 90 minutes,median follow-up time was 6 months,and all patients had clear resection margins.There was no residual,recurrent or cancer related death during short-term follow-up.Conclusion：Robotic nasopharyngectomy via combined approach of nose and mouth is safe,effective and has good local control.