Complications in transoral CO<sub>2</sub> laser surgery for carcinoma of the larynx and hypopharynx

Vilaseca, Isabel; Bernal‐Sprekelsen, Manuel; Blanch-Alejandro, Jose-Luis; Moragas-Lluis, M.

doi:10.1002/hed.10207

Cited by 124 publications

(109 citation statements)

References 21 publications

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“…One study focusing on the learning curve for transoral laser supraglottic laryngectomy found a significant correlation between surgical experience and compli cations. 12 In our previous study, TORS supraglottic laryngectomy in a canine model was found to have a short learning curve, and the time needed to com plete the procedure was less than 30 minutes. 4 The average time for the TORS supraglottic partial lar yngectomy in this study was 120 minutes, and al though this is longer than in the canine model, it is the authors' impression that the technical advan tages of the robotic system have contributed to the shortening of the learning curve in TORS supraglot tic partial laryngectomy.…”

Section: Discussionmentioning

confidence: 92%

Transoral Robotic Surgery: Supraglottic Partial Laryngectomy

Weinstein¹,

O’Malley²,

Snyder³

et al. 2007

Ann Otol Rhinol Laryngol

363

248

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Objectives:We assessed the feasibility of performing transoral supraglottic partial laryngectomy with robotic instrumen tation. Methods:Transoral robotic surgery (TORS) was performed on 3 human patients with supraglottic carcinoma in a pro spective human trial. The study was approved by our institutional review board and involved the da Vinci Surgical Robot (Intuitive Surgical, Inc, Sunnyvale, California).Results: All procedures were completed robotically. The median overall operation time to perform the robotic procedure was 120 minutes (range, 1:32:48 to 2:58:18), including 18 minutes (range, 00:6:07 to 00:30:39) for exposure and robotic positioning. There were no intraoperative or postoperative complications or surgical mortality. Conclusions:The preliminary results of our series suggest that application of the da Vinci robotic surgical system for TORS to supraglottic partial laryngectomy is technically feasible and relatively safe. Furthermore, TORS provides ex cellent surgical exposure that allows complete tumor resection. Most importantly, TORS provides an alternative to open approaches and "conventional" transoral supraglottic partial laryngectomy.

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Section: Discussionmentioning

confidence: 92%

Transoral Robotic Surgery: Supraglottic Partial Laryngectomy

Weinstein¹,

O’Malley²,

Snyder³

et al. 2007

Ann Otol Rhinol Laryngol

363

248

View full text Add to dashboard Cite

show abstract

“…Bernal et al [4] classifies postoperative complications in minors, when they are self-limited, can be managed with medical treatment and leave no sequelae, and mayors, when they required surgical resolution, intensive care or leave sequelae that may require a tracheostomy or gastrostomy feeding tube definitively [4]. Steiner & Ambrosch [5] had no intraoperative complications for the CO 2 laser technique, in 704 patients treated for tumors of the larynx and hypopharynx.…”

Section: Discussionmentioning

confidence: 99%

“…Other articles [4,8] mention an incidence of 0.4 to 8% for postoperative bleeding. In a multicenter study of transoral treatment in advanced tumors [9], it is reported, a postoperative bleeding of 6% and mortality of 5 % within 30 days after surgery.…”

Section: Discussionmentioning

confidence: 99%

Transoral Surgery for Laryngeal Cancer: Bleeding Complications

José¹

2016

JOENTR

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Submit Manuscript | http://medcraveonline.com IntroductionTransoral surgery is nowadays, the first therapeutic option in many centers around the world to treat laryngeal cancer with early T (Tis-T1-T2), and it is a possibility for the treatment of T3 tumors. This technique allows the use of different types of surgical dispositives, including radiofrequency, electrocautery and laser [1][2][3]. The advantage is that it has the same oncologic results that open surgery but with less morbidity [1]. Like any surgical technique, transoral surgery has possible complications, which are rare but should be taken into account; one of them is postoperative bleeding, which is the topic of discussion of this article. ObjectivesTo determine the incidence of postoperative bleeding in patients treated for laryngeal cancer by transoral surgery. DesignDescriptive and retrospective study. Materials and MethodsThe bleeding complications were registered in a Microsoft Office Excel table; also it was registered postoperative time of bleeding, location of the tumor in the larynx and stage, type of treatment of the complication, and sequelae/mortality, in all patients who were treated with transoral surgery for laryngeal cancer. Mild postoperative bleeding (bloody spittle) that occurred 24/48hours after surgery and did not require treatment were excluded.Transoral surgery was performed with electrocautery, radiofrequency or CO 2 laser in continuous mode with super pulse. A Newton microscope, MEC 5 LED OT s/XXI model, was used. Suspension laryngoscopes of different diameters, scalpel and monopolar protected of 24cm length, straight and angled forceps, micro scissors and dissectors straight and angled for laryngeal microsurgery were used. A Lumenis Acupulse CO 2 Laser was used. Patients were operated under general anesthesia. ResultsThere were treated 128 patients for laryngeal cancer with transoral surgery at the ENT department of Hospital Italiano de Buenos Aires between March of 2004 and April of 2016. One hundred and sixteen were men (91%), and twelve were women (9%), the average age was 62 years. 128 transoral surgeries (128 were primary surgeries and 20 reoperations for ampliation of the margins or persistence of the tumor) were performed. Three patients of 128 suffered postoperative bleeding and they required treatment. A patient operated of a glottic laryngeal cancer staged T1N0M0 using radiofrequency presented a bleeding 15 days after AbstractIntroduction: Transoral laser surgery is the treatment of choice in many centers for patients with laryngeal tumors with an early T (Tis-T1-T2) and in selected patients with T3 tumors. Outcomes are comparable to those of other therapeutic approaches that preserve laryngeal function. The aim of this study is to determine the postoperative incidence of hemorrhagic complications in patients treated for larynx tumors using a transoral approach.

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“…15,16 While the incidence of cervical emphysema caused by transoral CO 2 laser surgery for carcinoma of the larynx and pharynx is reported to be in the range of 1.1% (3/275 cases) to 7.3% (4/55 cases), 15,16 the incidence of emphysema caused by dental laser treatment is lower.…”

Section: Discussionmentioning

confidence: 99%