Background The anatomical complexity of the oropharynx and the difficulty in reaching its distal portion have always conditioned the surgical accessibility. Robotic surgery represents an excellent alternative in the treatment of cervico-facial oncological diseases. Methods This series comprises all patients managed for head and neck cancer by Trans Oral Robotic Surgery TORS. The staging assessment, including neck ultrasound and total body PET/CT scan, was performed in each patient according to the TNM classification. All charts were recorded with the following data: name and surname, age, gender, date of surgery intra or post-operative hemorragia, tumor site, histology, TNM stage, robot set-up time, tumor resection time, whether or not tracheotomy was performed, whether or not neck dissection was performed, insertion of a nasogastric tube or gastrostomy, time to resumption of oral feeding, surgical margins, mean length of hospital stay, adjuvant treatment and follow-up. Results From February 2013 to February 2018, TORS was performed in 67 consecutive patients affected by head and neck tumours. We divided, our sample, in 3 subsites: supraglottic larynx, parapharyngeal space and oropharynx. Pathology reports confimed malignancy in 44 cases: 8 cases lymphomas, 36 cases of Squamous cell carcinoma (SCC), 5 cases of benign salivary glands tumors and 18 miscellaneous cases. Neck dissection was performed in 12 cases. Tracheotomy was perfomed in 3/67 cases for respiratory failures. A nasogastric tube was inserted at the end of the surgical procedure in 21 patients. The mean length of hospital stay was 10 days . Major complications included post-operative bleeding in 3 patients, 1 exitus for massive bleeding 20 days post-surgery and 1 respiratory failure treated with tracheotomy and monitoring in the Intensive Care Unit (ICU) for 3 days. Conclusions Robotic surgery has been considered a valid alternative to traditional open treatment in many specializations with the advantages of an endoscopic procedure, with the same oncological and functional results and with fewer complications. The advantages of this type of surgical technique have been discussed, it is mandatory to focus on the indications and contraindications.

中文翻译：

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头颈区经口机器人手术：单中心67例患者的回顾性研究

背景 口咽部的解剖复杂性和到达其远端部分的困难一直限制着手术的可及性。机器人手术是治疗颈面部肿瘤疾病的绝佳选择。方法 该系列包括所有通过经口腔机器人手术 TORS 治疗的头颈癌患者。根据 TNM 分类对每位患者进行分期评估，包括颈部超声和全身 PET/CT 扫描。所有图表均记录以下数据：姓名、年龄、性别、手术日期或手术后出血、肿瘤部位、组织学、TNM 分期、机器人设置时间、肿瘤切除时间、是否气管切开进行，无论是否进行了颈部解剖，插入鼻胃管或胃造口术、恢复经口喂养的时间、手术切缘、平均住院时间、辅助治疗和随访。结果 2013 年 2 月至 2018 年 2 月，连续 67 例头颈部肿瘤患者接受了 TORS。我们将样本分为 3 个子位点：声门上喉、咽旁间隙和口咽。病理报告确诊为恶性肿瘤44例：淋巴瘤8例，鳞状细胞癌（SCC）36例，唾液腺良性肿瘤5例，其他18例。12例行颈清扫术。3/67 例因呼吸衰竭行气管切开术。21 名患者在手术结束时插入了鼻胃管。平均住院时间为10天。主要并发症包括 3 例患者术后出血，1 例术后 20 天因大出血而出院，1 例呼吸衰竭接受气管切开治疗并在重症监护室 (ICU) 监测 3 天。结论 机器人手术已被许多专业认为是传统开放治疗的有效替代方案，具有内窥镜手术的优点，具有相同的肿瘤学和功能结果，并且并发症更少。已经讨论了这种手术技术的优点，必须重点关注适应症和禁忌症。结论 机器人手术已被许多专业认为是传统开放治疗的有效替代方案，具有内窥镜手术的优点，具有相同的肿瘤学和功能结果，并且并发症更少。已经讨论了这种手术技术的优点，必须重点关注适应症和禁忌症。结论 机器人手术已被许多专业认为是传统开放治疗的有效替代方案，具有内窥镜手术的优点，具有相同的肿瘤学和功能结果，并且并发症更少。已经讨论了这种手术技术的优点，必须重点关注适应症和禁忌症。