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Ebisumoto K, Sakai A, Iijima H, Maki D, Yamauchi M, Saito K, Kaneda S, Teramura T, Watanabe T, Inagi T, Yanagiya R, Yamazaki A, Ashida H, Ota Y, Sato Y, Yamamoto A, Kobayashi N, Okami K. Safety and outcome of three-dimensional transoral videolaryngoscopic surgery. Head Neck 2024. [PMID: 38268328 DOI: 10.1002/hed.27657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/07/2023] [Accepted: 01/15/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Transoral videolaryngoscopic surgery (TOVS) is widely used in Japan, and conventional two-dimensional (2D) endoscopic methods have been established. Three-dimensional (3D) endoscopic surgery offers superior distance perception because it provides stereoscopic views. Recently, we have developed 3D endoscopy for TOVS (3D TOVS). METHODS This study included 46 patients with pharyngeal cancer who underwent 3D TOVS. The perioperative complications and survival curves were retrospectively analyzed. RESULTS One patient with oropharyngeal cancer who underwent neck dissection and transoral resection simultaneously experienced postoperative hemorrhage of the neck. Another patient with oropharyngeal cancer underwent hemostasis for postoperative pharyngeal hemorrhage. There was one case of aspiration pneumonia. One patient developed cervical lymph node recurrence; however, there was no local recurrence or primary mortality. The 2-year overall survival, disease-specific survival, local control rates, locoregional control rate, and invasive disease-free survival were 90.9%, 100%, 100%, 97.4%, and 79.9%, respectively. CONCLUSIONS Three-dimensional endoscopy can be safely applied to TOVS.
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Affiliation(s)
- Koji Ebisumoto
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Akihiro Sakai
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Hiroaki Iijima
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Daisuke Maki
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Mayu Yamauchi
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Kosuke Saito
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Shoji Kaneda
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Takanobu Teramura
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Takane Watanabe
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Toshihide Inagi
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Ryoko Yanagiya
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Aritomo Yamazaki
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Hiroshi Ashida
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Yoshiyuki Ota
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Yurina Sato
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Ai Yamamoto
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Naoya Kobayashi
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
| | - Kenji Okami
- Department of Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, Japan
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Tateya I, Shiotani A, Satou Y, Tomifuji M, Morita S, Muto M, Ito J. Transoral surgery for laryngo-pharyngeal cancer - The paradigm shift of the head and cancer treatment. Auris Nasus Larynx 2015; 43:21-32. [PMID: 26298233 DOI: 10.1016/j.anl.2015.06.013] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/26/2015] [Accepted: 06/22/2015] [Indexed: 12/11/2022]
Abstract
Transoral surgery is a less invasive treatment that is becoming a major strategy in the treatment of laryngo-pharyngeal cancer. It is a minimally invasive approach that has no skin incision and limits the extent of tissue dissection, disruption of speech and swallowing muscles, blood loss, damage to major neurovascular structures, and injury to normal tissue. Transoral approaches to the laryngo-pharynx, except for early glottis cancer, had been limited traditionally to tumors that can be observed directly and manipulated with standard instrumentation and lighting. Since the 1990s, transoral laser microsurgery (TLM) has been used as an organ preservation strategy with good oncological control and good functional results, although it has not been widely used because of its technical difficulty. Recently, transoral robotic surgery (TORS) is becoming popular as a new treatment modality for laryngo-pharyngeal cancer, and surgical robots are used widely in the world since United States FDA approval in 2009. In spite of the global spread of TORS, it has not been approved by the Japan FDA, which has led to the development of other low-cost transoral surgical techniques in Japan. Transoral videolaryngoscopic surgery (TOVS) was developed as a new transoral surgery system for laryngo-pharyngeal lesions to address the problems of TLM. In TOVS, a rigid endoscope is used to visualize the surgical field instead of a microscope and the advantages of TOVS include the wide operative field and working space achieved using the distending laryngoscope and videolaryngoscope. Also, with the spread of narrow band imaging (NBI), endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), which are widely used for superficial cancers in the gastrointestinal tract, have been applied for the superficial laryngo-pharyngeal cancer. Both EMR and ESD are performed mainly by gastroenterologists with a sharp dissector and magnifying endoscopy (ME)-NBI with minimal surgical margin. Endoscopic laryngo-pharyngeal surgery (ELPS) was developed to treat laryngo-pharyngeal superficial cancer by modifying the ESD procedure. The concept of ELPS is the same as that of ESD, however, the resection procedure is performed by a head and neck surgeon with both hands using a ME-NBI and rigid curved laryngo-pharyngoscope. These four procedures are low cost with similar oncological and functional outcomes to TORS. TORS may be less expensive than chemoradiotherapy, but the number of hospitals that can afford da Vinci surgical systems is limited. Even in the era of robotic surgery, these four procedures will be good options for laryngo-pharyngeal cancer.
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Affiliation(s)
- Ichiro Tateya
- Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kyoto University, Japan.
| | - Akihiro Shiotani
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Japan
| | - Yasuo Satou
- Department of Otolaryngology, Tachikawa Hospital, Japan
| | - Masayuki Tomifuji
- Department of Otolaryngology-Head and Neck Surgery, National Defense Medical College, Japan
| | - Shuko Morita
- Department of Gastroenterology, Kobe City Medical Center General Hospital, Japan
| | - Manabu Muto
- Department of Clinical Oncology, Graduate School of Medicine, Kyoto University, Japan
| | - Juichi Ito
- Department of Otolaryngology-Head & Neck Surgery, Graduate School of Medicine, Kyoto University, Japan; Shiga Medical Center Research Institute, Japan
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Ebisumoto K, Okami K, Ogura G, Sakai A, Sugimoto R, Saito K, Kaneda S, Hanakita T, Nakamura N, Iida M. The predictive role of infiltrative growth pattern in early pharyngeal cancers. Acta Otolaryngol 2015. [PMID: 26223893 DOI: 10.3109/00016489.2015.1072872] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION The infiltrative growth pattern may predict tumor depth and lymph node metastasis. INF-a seems to fall into a low-risk category, and no additional treatment may be required immediately. OBJECTIVES Tumor depth is a predictor of lymph node metastasis in early pharyngeal cancers. An infiltrative growth pattern is also a prognostic factor in other cancers. This study aimed to elucidate the predictive role of infiltrative growth pattern in early pharyngeal cancers. METHODS Thirty-eight lesions from 37 patients who had undergone trans-oral resection of pharyngeal cancers were included. According to the Japanese Classification of Esophageal Cancer, infiltrative growth pattern was classified into three groups; INF-a, INF-b, and INF-c. The correlation between infiltrative growth pattern and tumor depth, cervical lymph node metastasis was analyzed. RESULTS Of the 38 lesions, 25 were INF-a, nine were INF-b, and four were INF-c lesions. Lymph node metastasis was observed in three INF-b and one INF-c lesions. In contrast, no INF-a had lymph node metastasis. All INF-a lesions showed shallow invasion of the sub-epithelium; INF-b and INF-c lesions had significantly greater depth than INF-a.
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Affiliation(s)
| | - Kenji Okami
- a 1 Department of Otolaryngology-Head and Neck Surgery
| | - Go Ogura
- b 2 Department of Pathology, Tokai University , Kanagawa, Japan
| | - Akihiro Sakai
- a 1 Department of Otolaryngology-Head and Neck Surgery
| | | | - Kosuke Saito
- a 1 Department of Otolaryngology-Head and Neck Surgery
| | - Shoji Kaneda
- a 1 Department of Otolaryngology-Head and Neck Surgery
| | | | - Naoya Nakamura
- b 2 Department of Pathology, Tokai University , Kanagawa, Japan
| | - Masahiro Iida
- a 1 Department of Otolaryngology-Head and Neck Surgery
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