Background: Transoral robotic surgery (TORS) is a minimally invasive option for supraglottic laryngeal carcinoma (SGLC) with potential functional benefits without compromising oncologic control. We systematically reviewed functional outcomes and operative features of TORS for SGLC. Methods: A PRISMA-guided search of PubMed/MEDLINE, Embase, Scopus, and Cochrane (2007–2025) identified studies reporting functional outcomes after TORS for SGLC. Results: Twenty-one studies (n = 602) were included. Prophylactic tracheostomy was performed in approximately 21%, with 96% of whom were decannulated after a mean of 15 days. Feeding tubes (FT) were placed in 42%, with 92% subsequently removed after a mean dependence of 16 days; oral intake was typically resumed after approximately 5 days. PEG use was infrequent (~ 5%). Mean operative time was 64 min; mean estimated blood loss 53 mL; hospital stay was short. Complications were generally uncommon; hemorrhage requiring intervention was infrequent. Across the limited comparative literature, functional outcomes after TORS appeared broadly consistent with those reported for open approaches; however, no formal meta-analysis was performed and most included studies were retrospective. Conclusion: In selected SGLC, TORS appears to be associated with favorable airway and swallowing outcomes and low perioperative morbidity based on available retrospective evidence, without apparent compromise of oncologic control. These findings should be considered hypothesis-generating and warrant confirmation in prospective, comparative studies.
Transoral robotic surgery for supraglottic laryngeal cancer: A systematic review of functional outcomes and operative features
Guarino, PierreUltimo
2025-01-01
Abstract
Background: Transoral robotic surgery (TORS) is a minimally invasive option for supraglottic laryngeal carcinoma (SGLC) with potential functional benefits without compromising oncologic control. We systematically reviewed functional outcomes and operative features of TORS for SGLC. Methods: A PRISMA-guided search of PubMed/MEDLINE, Embase, Scopus, and Cochrane (2007–2025) identified studies reporting functional outcomes after TORS for SGLC. Results: Twenty-one studies (n = 602) were included. Prophylactic tracheostomy was performed in approximately 21%, with 96% of whom were decannulated after a mean of 15 days. Feeding tubes (FT) were placed in 42%, with 92% subsequently removed after a mean dependence of 16 days; oral intake was typically resumed after approximately 5 days. PEG use was infrequent (~ 5%). Mean operative time was 64 min; mean estimated blood loss 53 mL; hospital stay was short. Complications were generally uncommon; hemorrhage requiring intervention was infrequent. Across the limited comparative literature, functional outcomes after TORS appeared broadly consistent with those reported for open approaches; however, no formal meta-analysis was performed and most included studies were retrospective. Conclusion: In selected SGLC, TORS appears to be associated with favorable airway and swallowing outcomes and low perioperative morbidity based on available retrospective evidence, without apparent compromise of oncologic control. These findings should be considered hypothesis-generating and warrant confirmation in prospective, comparative studies.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
