Transoral robotic surgery for pediatric upper airway pathology: An institutional update

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-15 DOI:10.1016/j.ijporl.2024.112073

Cameron P. Worden , Andrew C. Prince , Samuel N. Kirse , Christopher Rutter , Benjamin H. Shields , Trevor G. Hackman , Wendell G. Yarbrough , Adam M. Zanation , Carlton J. Zdanski

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引用次数: 0

Abstract

Objective

Provide an update on our institution's experience with utilizing transoral robotic surgery (TORS) in pediatric airway surgery and compare these results to surgery by traditional methods.

Methods

Pediatric patients who underwent TORS for treatment of upper airway pathology between 2010 and 2021 at our institution were retrospectively identified and compared to patients with the same or similar pathology who underwent a traditional (open or endoscopic) surgical approach over the same time period. Outcomes of interest included patient demographics, operative times, adverse events, hospital length of stay (LOS), and modified barium swallow (MBSS) results.

Results

Forty children (19M, 21F) underwent 46 TORS procedures. Mean age was 6.4 years (range: 6 days-17 years). Most commonly treated pathology included: laryngeal clefts (LC) (n = 18), lymphatic malformations (n = 9), and base of tongue masses (n = 7). Surgical time was decreased in traditional type I LC repairs (mean: 111 vs 149 min, P = 0.04) and lymphatic malformation excisions (59 vs 120 min, p = 0.005). Hospital LOS was increased in TORS type I LC repairs (2.6 vs 1.2 days, P = 0.04). Adverse event rate was similar between TORS and traditional cohorts (17 % vs 16 % cases, P = 0.9). Postoperative MBSS results were improved for TORS type I LC repairs at 6 months (70 % vs 33 %, P = 0.09) and 12 months (82 % vs 43 %, P = 0.05).

Conclusions

Pediatric TORS is practical and safe and has comparable outcomes to traditional surgery. Robotic-assisted LC repair displayed improved postoperative swallow results versus traditional approaches and may be particularly useful in recurrent cases.

Level of evidence

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经口机器人手术治疗小儿上气道病变：机构更新

方法回顾性研究2010年至2021年期间在我院接受经口机器人手术（TORS）治疗上气道病变的儿童患者，并与同期接受传统（开放式或内窥镜）手术治疗的具有相同或相似病变的患者进行比较。相关结果包括患者人口统计学、手术时间、不良事件、住院时间（LOS）和改良钡吞咽（MBSS）结果。平均年龄为 6.4 岁（6 天-17 岁）。最常治疗的病理包括：喉裂（LC）（18 例）、淋巴畸形（9 例）和舌根肿块（7 例）。传统的 I 型 LC 修复手术（平均：111 分钟对 149 分钟，P = 0.04）和淋巴畸形切除手术（59 分钟对 120 分钟，P = 0.005）的手术时间缩短。TORS I 型 LC 修复术的住院时间延长（2.6 对 1.2 天，P = 0.04）。TORS 和传统手术的不良事件发生率相似（17% 对 16%，P = 0.9）。TORS I 型 LC 修复术后 6 个月（70% 对 33%，P = 0.09）和 12 个月（82% 对 43%，P = 0.05）的 MBSS 结果均有所改善。与传统方法相比，机器人辅助 LC 修复术的术后吞咽效果更好，尤其适用于复发病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.