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Original Article
April 2009

Robot-Assisted Surgery for Upper Aerodigestive Tract Neoplasms

Author Affiliations

Author Affiliations: Department of Surgery, Division of Otolaryngology–Head and Neck Surgery (Drs Boudreaux, Rosenthal, Magnuson, Newman, and Carroll and Ms Clemons), and Department of Medicine, Medical Statistics Section, Biostatistics and Bioinformatics Unit (Dr Desmond), University of Alabama at Birmingham.

Arch Otolaryngol Head Neck Surg. 2009;135(4):397-401. doi:10.1001/archoto.2009.24

Objectives  To assess the feasibility and safety of performing robot-assisted resections of head and neck tumors, and to predict which variables lead to successful robot-assisted resection and better functional outcome.

Design  Prospective nonrandomized clinical trial.

Setting  Academic tertiary referral center.

Patients  Thirty-six patients with oral cavity, oropharyngeal, hypopharyngeal, or laryngeal tumors.

Intervention  Robot-assisted resection of indicated tumors.

Main Outcome Measures  Ability to perform robot-assisted resection, final pathologic margin status, ability to extubate postoperatively, need for tracheotomy tube, and need for gastrostomy tube. Any clinically significant complications were recorded.

Results  Thirty-six patients participated in the study. Eight patients had previously been treated for head and neck cancer. Twenty-nine patients (81%) underwent successful robotic resection. Negative margins were obtained in all 29 patients. Twenty-one of 29 patients were safely extubated prior to leaving the operating room. One patient required short-term tracheotomy tube placement. A total of 9 patients were gastrostomy tube dependent (2 preoperatively, 7 postoperatively). Factors associated with successful robotic resection were lower T classification (P = .01) and edentulism (P = .07). Factors associated with gastrostomy tube dependence were advanced age (P = .02), tumor location in the larynx (P < .001), higher T classification (P = .02), and lower preoperative M. D. Anderson Dysphagia Inventory score (P = .04).

Conclusions  Robot-assisted surgery is feasible and safe for the resection of select head and neck tumors. This clinical series demonstrates that robotic surgery can be utilized successfully in patients with T1 to T4 lesions located in the oral cavity, oropharynx, hypopharynx, and larynx with good preservation of swallow function.

Trial Registration  clinicaltrials.gov Identifier:NCT00473564