Skip to main content
SpringerLink
Log in

Minimally invasive supraomohyoid neck dissection by total endoscopic technique for oral squamous carcinoma

  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background and objective

To study the feasibility of a total endoscopic technique for selective neck dissection in oral cancers and to compare the technique with conventional open technique with a long cervical scar.

Methods

We included patients with early intraorally resectable squamous carcinomas and excluded patients whose primary lesion required reconstruction with microvascular flaps. We compared the following intraoperative parameters: cumulative length of the incision(s), duration of surgery, estimated blood loss, and intraoperative complications. The postoperative parameters included hospital stay, shoulder function, duration of analgesic use, and early postoperative complications. We used Shoulder Pain And Disability Index scores to assess shoulder function and assessed the oncologic outcome histopathologically by the number of nodes dissected.

Results

The mean operative time for minimally invasive supraomohyoid neck dissection (MISOND) was 53.7 ± 29.8 min, which was significantly longer than 39.4 ± 5.0 min for the open technique. The estimated blood loss in the MISOND group was significantly lower compared with the open technique (p < 0.001), and there were no major intraoperative complications in either group. Postoperative recovery assessed by hospital stay and time to resume routine work was slightly shorter in the MISOND group but not statistically significant. There were no reported early postoperative complications such as haemorrhage, wound dehiscence, or chyle leakage in either group. The mean Shoulder Pain And Disability Index score assessed 2 weeks postoperatively for the MISOND group was 14.35 ± 0.71 %, which was significantly better than 44.14 ± 1.18 % for the open technique (p < 0.001). The number of nodes dissected showed no significant difference between groups.

Conclusions

MISOND is a feasible and safe procedure with immediate oncologic outcomes comparable with those of conventional open SOND and provides better cosmetic and functional outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Gagner M (1996) Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg 83:875

    Article  CAS  PubMed  Google Scholar 

  2. Yeung HC, Ng WT, Kong CK (1997) Endoscopic thyroid and parathyroidectomy surgery. Surg Endosc 11:1135

    Article  CAS  PubMed  Google Scholar 

  3. Moural M, Pugin F, Elias B, Malaise J, Coche E, Jamar F et al (2002) Contribution of the video assisted approach to thyroid and parathyroid surgery. Acta Chir Belg 102:323–328

    Article  Google Scholar 

  4. Ikeda Y, Takami H, Niimi M, Kan S, Sasaki Y, Takayama J (2002) Endoscopic thyroidectomy and parathyroidectomy by the axillary approach. A preliminary report. Surg Endosc. 16:92–95

    Article  CAS  PubMed  Google Scholar 

  5. Maeda S, Shimizu K, Minami S, Hayashida N, Kuroki T, Furuichi A et al (2002) Video-assisted neck surgery for thyroid and parathyroid diseases. Biomed Pharmacother 56:92s–95s

    Article  PubMed  Google Scholar 

  6. Gagner M, Inabnet BW 3rd, Bierthoh L (2003) Endoscopic thyroidectomy for solitary nodules. Ann Chir 128:696–701

    Article  CAS  PubMed  Google Scholar 

  7. Ikeda Y, Takami H, Sasaki Y, Kan S, Niimi M (2000) Endoscopic neck surgery by the axillary approach. J Am Coll Surg 191:336–340

    Article  CAS  PubMed  Google Scholar 

  8. Cougard P, Osmak L, Esquis P, Ognois P (2005) Endoscopic thyroidectomy. A preliminary report including 40 patients. Ann Chir 130:81–85

    Article  CAS  PubMed  Google Scholar 

  9. Chantawibul S, Lokechareonlarp S, Pokawatana C (2003) Total video endoscopic thyroidectomy by an axillary approach. J Laparoendosc Adv Surg Tech A 13:295–299

    Article  PubMed  Google Scholar 

  10. Guyot L, Duroure F, Richard O, Lebeau J, Passagia JG, Raphael B (2005) Submandibular gland endoscopic resection: a cadaveric study. Int J Oral Maxillofac Surg 34:407–410

    Article  CAS  PubMed  Google Scholar 

  11. Ruggieri M, Straniero A, Pacini FM, Maiuolo A, Mascaro A, Genderini M (2003) Video assisted surgery of the thyroid diseases. Eur Rev Med Pharmacol Sci 7:91–96

    CAS  PubMed  Google Scholar 

  12. Shimizu K, Tanaka S (2003) Asian perspective on endoscopic thyroidectomy: a review of 193 cases. Asian J Surg 26:92–100

    Article  PubMed  Google Scholar 

  13. Miccoli P, Berti P, Raffaelli M, Materazzi G, Baldacci S, Rossi G (2000) Comparison between minimally invasive video assisted thyroidectomy and conventional thyroidectomy: a prospective randomized study. Surgery 130:1039–1043

    Article  Google Scholar 

  14. Gauger PG, Reeve TS, Delbridge LW (1999) Minimal access/minimally invasive parathyroidectomy. Br J Surg 86:1563–1566

    Article  CAS  PubMed  Google Scholar 

  15. Palazzo FF, Delbridge LW (2004) Minimal access/minimally invasive parathyroidectomy for primary hyperparathyroidism. Sirg Clin North Am 84:717–734

    Article  Google Scholar 

  16. Gosnell JE, Sackett WR, Sidhu S, Sywak M, Reeve TS, Delbridge LW (2004) Minimal access thyroid surgery: technique and report of the first 25 cases. ANZ J Surg. 74:330–334

    Article  PubMed  Google Scholar 

  17. Malinvaud D, Potard G, Fortun C, Saraux A, Jezequel JA, Marianowski R (2004) Management of primary hyperthyroidism: toward minimal access surgery. Jt Bone Spine 71:111–116

    Article  Google Scholar 

  18. Lowney JK, Weber B, Johnson S, Doherty GM (2000) Minimal incision parathyroidectomy: care, cosmesis and cost. World J Surg 24:1442–1445

    Article  CAS  PubMed  Google Scholar 

  19. Rodrigo JP, Shah JP, Silver CE et al (2011) Management of the clinically negative neck in early-stage head and neck cancers after transoral resection. Head Neck 33:1210–1219

    Article  PubMed  Google Scholar 

  20. Wei WI, Ferlito A, Rinaldo A et al (2006) Management of the N0 neck—reference or preference. Oral Oncol 42:115–122

    Article  PubMed  Google Scholar 

  21. Ferlito A, Rinaldo A, Silver CE et al (2006) Elective and therapeutic selective neck dissection. Oral Oncol 42:13–24

    Article  Google Scholar 

  22. Ferlito A, Silver CE, Rinaldo A (2009) Elective management of the neck in oral cavity squamous carcinoma: current concepts robot-assisted supraomohyoid neck dissection 3877 supported by prospective studies. Br J Oral Maxillofac Surg 47:5–9

    Article  PubMed  Google Scholar 

  23. Pentenero M, Gandolfo S, Carrozzo M (2005) Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck 27:1080–1091

    Article  PubMed  Google Scholar 

  24. Kang SW, Lee SH, Ryu HR, Lee KY, Jeong JJ, Nam KH et al (2010) Initial experience with robot-assisted modified radical neck dissection for the management of thyroid carcinoma with lateral neck node metastasis. Surgery 148:1214–1221

    Article  PubMed  Google Scholar 

  25. Lee HS, Kim WS, Hong HJ, Ban MJ, Lee D, Koh YW et al (2012) Robot-assisted Supraomohyoid neck dissection via a modified face-lift or retroauricular approach in early-stage cN0 squamous cell carcinoma of the oral cavity: a comparative study with conventional technique. Ann Surg Oncol 19:3871–3878

    Article  PubMed  Google Scholar 

  26. Byeon HK, Holsinger FC, Koh YW, Ban MJ, Ha JG, Park JJ et al (2014) Endoscopic supraomohyoid neck dissection via a retroauricular or modified facelift approach: preliminary results. Head Neck 36(3):425–430. doi:10.1002/hed.23308 (Epub 2013 Jun 1)

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Dr. Ravindrasinh Raj, Dr. Vikram Lotwala, and Dr. Piyush Anajwala have no conflict of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Bharat Cancer Hospital and Research Institute, Saroli, Kadodara Road, Surat, 395010, Gujarat, India

    Ravindrasinh Raj

  2. Department of Minimal Access Surgery, Bharat Cancer Hospital and Research Institute, Surat, India

    Vikram Lotwala & Piyush Anajwala

Authors
  1. Ravindrasinh Raj
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vikram Lotwala
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Piyush Anajwala
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ravindrasinh Raj.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raj, R., Lotwala, V. & Anajwala, P. Minimally invasive supraomohyoid neck dissection by total endoscopic technique for oral squamous carcinoma. Surg Endosc 30, 2315–2320 (2016). https://doi.org/10.1007/s00464-015-4427-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-015-4427-z

Keywords

Search

Navigation