Comparison of Transoral Robotic Surgery and Endoscopic Laryngopharyngeal Surgery for Hypopharyngeal and Supraglottic Laryngeal Cancers

Abstract

Objectives: We aimed to compare intraoperative and postoperative outcomes, technical advantages, and limitations of transoral robotic surgery (TORS) using the Da Vinci Xi robotic system and endoscopic laryngopharyngeal surgery (ELPS) for hypopharyngeal and supraglottic laryngeal cancers. Methods: This single-center retrospective cohort study analyzed preoperative variables, intraoperative data, postoperative complications, and functional outcomes in patients with hypopharyngeal and supraglottic laryngeal cancers who underwent TORS or ELPS. Results: Fifty patients were enrolled (21: TORS; 29: ELPS). Median age at treatment was 73 years (range, 51–87 years). Median resection time was significantly shorter for ELPS (23 min, range 6–124) than for TORS (42 min, range 6–155; p < 0.001). No significant association was observed between surgical approach and postoperative complication incidence. Multivariate analysis identified the presence of subepithelial invasion (p = 0.0089) as an independent predictor of postoperative complications. Conclusion: ELPS had a shorter resection time than TORS; however, both approaches showed no significant differences in safety and efficacy.