Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Supracricoid Partial Laryngectomy For Salvage Surgery After Failure of Transoral Robotic Surgery For Glottic Carcinoma
Glottik Transoral Robotic Cerrahi Sonrası Nükslerde Suprakrikoid Parsiyel Larinjektominin Yeri
Selçuk GÜNEŞa
aDepartment of Otolaryngology Head and Neck Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, TURKEY
Turkiye Klinikleri J Med Sci. 2019;39(2):144-9
doi: 10.5336/medsci.2018-63243
Article Language: EN
Full Text
ABSTRACT
 Objective: Organ preservation strategy in laryngeal carcinoma is now the fundamental treatment choice in laryngeal carcinoma. Endolaryngeal surgery (ELS) is one of the successful treatment modalities for organ preservation. With the introduction of transoral robotic surgery (TORS) into glottic laryngeal cancer treatmet options, TORS failure patient management became more important for surgeons interested in head and neck surgery. The aim of this study was to evaluate the functional results, local control, and survival rates in a series of 7 patients who were consecutively managed with Supracricoid Partial Laryngectomy (SCPL) for persistent and recurrence tumors after TORS cordectomy. Material and Methods: Patients who underwent SCPL after failed TORS cordectomy over a seven-year period were enrolled in the study. The patients' age, sex, previous cordectomy type, tumor stage, recurrence interval, recurrence stage, neck dissection adjuvant therapy, decannulation time, and start to oral feeding type were recorded. Results: After salvage surgery, the mean decannulation time was 17.4±3.49 days in 5 patients who could be decannulated. The mean oral intake time was 26.57±23.66 days. The recurrence rate was 14.28% (1/7). The local control rate and organ preservation rate was 85.72%. The functional preservation rate was 71.42%. All patients are feeding orally (100%). Conclusion: With suitable oncologic and functional rates, SCPL is a feasible surgical choice after TORS failure.

Keywords: Glottic cancer; partial laryngectomy; recurrence; robotic surgery; larynx
ÖZET
 Amaç: Laringeal karsinomlardada organ koruma stratejisi, temel tedavi seçeneğidir. Endolaringeal cerrahi (ELS) organ korunmasında başarılı tedavi yöntemlerinden biridir. Transoral robotik cerrahinin (TORS) glottik laringeal kanser tedavi seçeneklerine girmesiyle, TORS sonrası nüks etmiş hastaların yönetimi baş ve boyun cerrahisi ile ilgilenen cerrahlar için daha önemli hale gelmiştir. Bu çalışmanın amacı, TORS kordektomi sonrası nüks eden ve Suprakrikoid Parsiyel Larenjektomi (SKPL) ile tedavi edilen 7 hastadan oluşan bir seride fonksiyonel sonuçları, lokal kontrol ve sağkalım oranlarını değerlendirmektir. Gereç ve Yöntemler: Yedi yıl içinde TORS kordektomisi sonrası nüks eden ve SKPL uygulanan hastalar çalışmaya alındı. Hastaların yaşı, cinsiyeti, önceki kordektomi tipi, tümör evresi, nüks aralığı, nüks evresi, boyun diseksiyonu adjuvan tedavisi, dekanülasyon süresi ve oral beslenmeye geçilme süresi kaydedildi. Bulgular: Kurtarma ameliyatından sonra, dekanüle edilebilen 5 hastada ortalama dekanülasyon süresi 17,4 ±3,49 gündü. Ortalama oral alım süresi 26,57±23,66 gündü. Nüks oranı %14,28 (1/7) idi. Lokal kontrol oranı ve organ koruma oranı %85,72 idi. Fonksiyon koruma oranı %71,42 idi. Tüm hastalarda oral yolla beslenme sağlandı (%100). Sonuç: Uygun onkolojik ve fonksiyonel oranlar ile TORS başarısızlığından sonra SKPL uygun bir cerrahi seçimdir.

Anahtar Kelimeler: Glottik kanser; parsiyel larinjektomi; rekürrens; robotik cerrahi; larinks
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