Transoral Resection of the Pharyngeal and Laryngeal Cancers

Abstract

Objective: Evaluate the efficacy and safety of the transoral en bloc resection of superficial pharyngeal and laryngeal cancers. Transoral tumor resection is one option of minimally invasive surgery. Method: From 2008 to 2010, 34 lesions (from 31 patients) were resected transorally under microscope with monopolar cautery. Results: Twenty-four hypopharyngeal, 4 oropharyngeal, and 6 laryngeal cancers were operated on using this method. Operation field was widely exposed with wide caliber scope or extending laryngoscope. Bimanual procedure under microscope enabled us to achieve en bloc resection. Radical neck dissection was done simultaneously in one case. Local control rate was 97%. No postoperative dyspnea or dysphagia was observed. Two-thirds of the patients had no symptoms, which were detected by screening of the esophageal cancer patients. Narrow Band Imaging (NBI) system was very useful for detection of the superficial lesions. Conclusion: Transoral robotic surgery is now applied for minimally invasive surgery, which is not applicable yet in Japan. Our technique of en bloc resection can be easily introduced and was effective in maintaining the quality of life after treatment.