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Transoral robotic cordectomy for glottic carcinoma: a rapid review

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Abstract

Objective

The objective of this study was to investigate feasibility, surgical, oncological, and functional outcomes of transoral robotic cordectomy (TORS-Co) and whether TORS-Co reported comparable outcomes of transoral laser microsurgery (TLM).

Methods

PubMed, Scopus, and Cochrane Library were searched by three laryngologists for studies investigating feasibility, surgical, oncological, and functional outcomes of patients benefiting from TORS-Co. The following outcomes were investigated according to the PRISMA statements: age; cT stage; types of cordectomy; surgical settings; complications; and functional and feasibility features.

Results

Nine studies published between 2009 and 2021 met our inclusion criteria, accounting for 114 patients. There was no controlled study. TORS-Co was performed in cT1 or cT2 glottic cancer through types II, III, IV, V, or VI cordectomies. The exposure was inadequate in 4% of cases, leading to conversion in transoral laser cordectomy. Margins were positive in 4.5% and local recurrence occurred in 10.7% (N = 8/75). Tracheotomy and feeding tube requirement varied across studies, depending on the types of TORS-Co. The mean duration of robot installation/vocal cord exposure and operative times ranged from 20 to 42 min and 10 to 40 min, respectively. The mean duration of hospital stay ranged from 2 to 7 days. Complications included dyspnea, bleeding, granuloma, synechia, and tongue hematoma and dysesthesia.

Conclusion

The current robotic systems do not appear adequate for TORS-Co. TORS-Co was associated with higher rates of complications and tracheotomy than TLM.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France

    Jérôme R. Lechien, Robin Baudouin, Marta P. Circiu, Lise Crevier-Buchman & Stephane Hans

  2. Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium

    Jérôme R. Lechien

  3. Department of Otolaryngology, Elsan Hospital, Paris, France

    Jérôme R. Lechien

  4. Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain

    Carlos M. Chiesa-Estomba

  5. Phonetics and Phonology Lab, CNRS UMR7018, Univ. Sorbonne University, Paris, France

    Lise Crevier-Buchman & Stephane Hans

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  1. Jérôme R. Lechien
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Correspondence to Jérôme R. Lechien.

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Lechien, J.R., Baudouin, R., Circiu, M.P. et al. Transoral robotic cordectomy for glottic carcinoma: a rapid review. Eur Arch Otorhinolaryngol 279, 5449–5456 (2022). https://doi.org/10.1007/s00405-022-07514-4

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  • DOI: https://doi.org/10.1007/s00405-022-07514-4

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