Clinical outcomes of end-flexible-rigidscopic transoral surgery (E-TOS) in patients with T1-selected T3 pharyngeal and supraglottic cancers

Watanabe, Yoshiki; Tanaka, Shinzo; Hiratsuka, Yasuyuki; Yamazaki, Hiroshi; Yoshida, Tsuyoshi; Kusano, Junko; Morita, Isao; Matsunaga, Momoko; Kitano, Masayuki; Yamaguchi, Tomoya

doi:10.1080/00016489.2018.1532106

Cited by 4 publications

(7 citation statements)

References 18 publications

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“…Transoral robotic surgery (TORS) using the da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) is the mainstream surgical technique in several countries. However, in Japan, non‐robotic transoral surgeries, such as end‐flexible‐rigidscopic transoral surgery (E‐TOS), 1 endoscopic laryngo‐pharyngeal surgery (ELPS), 2 and transoral videolaryngoscopic surgery (TOVS), 3 are mainly performed, as TORS was not covered by insurance until April 2022.…”

Section: Introductionmentioning

confidence: 99%

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Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

Watanabe

Tanaka²,

Hasebe

et al. 2022

The Laryngoscope

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Objective End‐flexible‐rigidscopic transoral surgery (E‐TOS) is a new and minimally invasive transoral surgery for resection of Tis‐selected T3 pharyngolaryngeal cancers. We evaluated long‐term oncological outcomes and whether postoperative voice and swallowing function were preserved following E‐TOS. Methods In this retrospective single‐center study, 154 patients treated with E‐TOS using a curved retractor, flexible‐tip rigid endoscope, and thin curved instruments were included. Their survival rate, larynx preservation rate, and disease control rate were estimated using the Kaplan–Meier method. Postoperative voice function was evaluated using both objective and subjective tests. Postoperative swallowing function was assessed using the Hyodo score and the functional outcome swallowing scale. Results The 3‐year and 5‐year overall survival, disease‐specific survival, disease‐free survival, laryngectomy‐free survival, local control, and loco‐regional control rates post E‐TOS were 89.8% and 82.2%, 95.6% and 92.3%, 78.5% and 70.3%, 87.2% and 80.9%, 93.9% and 92.5%, and 87.2% and 85.7%, respectively. Both objective and subjective postoperative voice and swallowing function tests were within normal limits in more than 90% of the patients. Conclusion E‐TOS is an effective, safe, low‐cost, and minimally invasive transoral surgery for Tis‐selected T3 pharyngolaryngeal cancer; it also preserves postoperative voice, larynx, and swallowing function. Level of Evidence 4 Laryngoscope, 133:1415–1424, 2023

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Section: Introductionmentioning

confidence: 99%

“…E‐TOS is a new, minimally invasive, non‐robotic, transoral surgery for pharyngolaryngeal cancer resection 1 that was invented by the authors ( R.A. and Y.W. ) and was first performed in 2010 at Kyoto Medical Center, the authors' former affiliation.…”

Section: Introductionmentioning

confidence: 99%

Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

Watanabe

Tanaka²,

Hasebe

et al. 2022

The Laryngoscope

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“…Next, fibrin glue (fibrinogen liquid and thrombin liquid) is sprayed around the wound surface. Since the introduction of E‐TOS at Kyoto Medical Center in 2010, we have used the MCFP technique for transoral coverage of mucosal and/or muscle layer defects involving the laryngopharyngeal lumen to prevent postoperative complications . However, we experienced the following problems.…”

Section: Introductionmentioning

confidence: 99%

“…Endoscopic transoral surgeries, including transoral robotic surgeries [1][2][3] and nonrobotic transoral surgeries such as end-flexible-rigidscopic transoral surgery (E-TOS), 4,5 endoscopic laryngopharyngeal surgery (ELPS), 6 and transoral videolaryngoscopic surgery (TOVS), 7,8 are performed as minimally invasive local treatment procedures for carcinoma insitu (Tis) and T1-T3 pharyngeal and supraglottic cancers. In patients with Tis or superficial cancers (cancers that invade the subepithelial layer but not the muscular layer), the mucosal layer at the primary site of involvement is resected.…”

Section: Introductionmentioning

confidence: 99%

“…Since the introduction of E-TOS at Kyoto Medical Center in 2010, we have used the MCFP technique for transoral coverage of mucosal and/or muscle layer defects involving the laryngopharyngeal lumen to prevent postoperative complications. 4,5 However, we experienced the following problems. First, the PGA sheet was frequently blown away from the wound surface by the air pressure of the fibrin spray.…”

Section: Introductionmentioning

confidence: 99%

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Defect repair with fibrin glue/polyglycolic acid after endoscopic laryngopharyngeal cancer resection

et al. 2019

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Objectives/Hypothesis In 2013, we introduced a modified technique for mucosal/muscle layer defect coverage with fibrin glue and polyglycolic acid (PGA) sheets (mMCFP technique) in patients undergoing endoscopic transoral surgeries for laryngopharyngeal cancers. This technique allows easy and convenient coverage of the wound surface, even when it involves the laryngopharyngeal lumen. To our knowledge, use of the MCFP technique for coverage of postoperative mucosal and/or muscle layer defects involving the laryngopharyngeal lumen has not been reported. The aim of the present study was to retrospectively evaluate the safety of our mMCFP technique used simultaneously with endoscopic transoral resection of Tis, T1, T2, and select T3 pharyngeal and supraglottic cancers. Study Design A single centre retrospective study. Methods Between June 2013 and February 2019, 102 patients underwent simultaneous end‐flexible‐rigidscopic transoral surgery and wound coverage using our mMCFP technique. All patients required mucosal and/or muscle layer resection. For all patients, we recorded the incidence of postoperative complications and the time period for which the PGA sheets could be observed after surgery. Results In 41%, 35%, and 8% patients, the PGA sheets could be observed on the wound surface for 2, 3, and 4 weeks, respectively. Other than postoperative bleeding in two patients (2%), no postoperative complications were recorded. Conclusions The findings of this study suggest that our mMCFP technique is a safe and simple method for the repair of mucosal and/or muscle layer defects after endoscopic transoral surgery for laryngopharyngeal cancers. Level of Evidence 4 Laryngoscope, 130:1740–1745, 2020

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Evaluating of Supraglottic Subunits in Swallowing Function in Supraglottic Cancer Patients Pre- and Post-Transoral Laser Microsurgery

Ahmadi,

Sanaei,

Abedin

et al. 2024

Indian J Otolaryngol Head Neck Surg

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Clinical outcomes of end-flexible-rigidscopic transoral surgery (E-TOS) in patients with T1-selected T3 pharyngeal and supraglottic cancers

Cited by 4 publications

References 18 publications

Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

Long‐Term Outcomes of End‐Flexible‐Rigidscopic Transoral Surgery for Pharyngolaryngeal Cancer

Defect repair with fibrin glue/polyglycolic acid after endoscopic laryngopharyngeal cancer resection

Evaluating of Supraglottic Subunits in Swallowing Function in Supraglottic Cancer Patients Pre- and Post-Transoral Laser Microsurgery

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