Clinical outcomes of end-flexible-rigidscopic transoral surgery (E-TOS) in patients with T1-selected T3 pharyngeal and supraglottic cancers |
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Authors: | Yoshiki Watanabe Shinzo Tanaka Yasuyuki Hiratsuka Hiroshi Yamazaki Takao Yoshida Junko Kusano |
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Institution: | 1. Otolaryngology-Head &2. Neck Surgery, Osaka Red Cross Hospital, Osaka, Japanywatanabe@osaka-med.jrc.or.jp;4. Neck Surgery, Osaka Red Cross Hospital, Osaka, Japan |
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Abstract: | Background: Endoscopic laryngo-pharyngeal surgery (ELPS), which is a transoral minimally invasive surgery using a gastrointestinal endoscope and a curved laryngopharyngeal retractor, is effective to treat primary lesions of superficial laryngopharyngeal cancers. To extend concepts of ELPS to invasive laryngopharyngeal cancers, we developed end-flexible-rigidscopic transoral surgery (E-TOS) from ELPS by changing a gastrointestinal endoscope to a flexible-tip rigid endoscope.Aims/Objectives: To retrospectively evaluate oncological outcomes and laryngopharyngeal functional preservation of E-TOS in patients with T1-selected T3 laryngopharyngeal cancers.Material and methods: In 47 patients T1-selected T3 pharyngeal and supraglottic cancers were resected by E-TOS using the flexible-tip rigid endoscope and curved instruments. Negative resection margin was histopathologically evaluated. The survival, preservation of larynx, and disease control rates were estimated using Kaplan-Meier method.Results: Curative resection was achieved in 94% of patients. No patient complained prolonged swallowing dysfunction or hoarseness after E-TOS. Postoperative bleeding, stenosis of the pharynx and esophageal entrance, and local recurrence was observed each in one patient. The 3-year overall survival, disease-specific survival, laryngeal preservation, local control, and locoregional control rates were, 86%, 93%, 100%, 98%, and 79%, respectively.Conclusion: E-TOS is an effective minimally invasive surgery for T1-selected T3 pharyngeal and supraglottic cancers with preserving laryngeal function. |
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Keywords: | Endoscopic surgery endoscope transoral surgery pharyngeal cancer laryngeal cancer supraglottic cancer minimally invasive surgery |
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