[en] [en] OBJECTIVE: To assess the opinion, practices, and challenges of international key opinion leaders about two minimal invasive surgical techniques in supraglottic laryngeal tumours: transoral laser microsurgery (TLM) and the transoral robotic surgery (TORS).
METHODS: Design of a questionnaire composed of seven sections and fifty questions covering descriptive data of participants, practitioners experience procedural sequences, considerations related to airways, feeding, and voice, intraoperative haemorrhage, postoperative management, and a comparative analysis of TLM and TORS in treating supraglottic laryngeal cancer.
RESULTS: A total of 27 head and neck surgeons replied to the survey. The experts had an average experience in laryngeal surgery of 20.0 ± 9.4 years, ranging from 5 to 36 years. We noted a significantly shorter installation time in TLM compared to TORS (19% of experts estimated the installation time of over 20 min with TLM vs 44% with TORS; p = 0.02). According to complications, the experts considered that bleeding was the major concern with supraglottic laryngeal surgery, especially intraoperative bleeding in TLM (52% in TLM vs 26% in TORS) (p = 0.09) and postoperative bleeding in TORS (56% in TORS vs 44% in TLM).
CONCLUSION: The experts did not identify a clear superiority of one technology (TLM) over the other (TORS). The two techniques seemed equivalent to the experts, except for the control of intraoperative haemostasis and visualisation of the surgical field, where TORS was perceived as superior to TLM.
Disciplines :
Otolaryngology
Author, co-author :
Loubieres, Charlotte; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France ; School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
Hans, Stéphane; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France ; School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France ; Phonetics and Phonology Laboratory (UMR 7018 CNRS &, Université Sorbonne Nouvelle), Paris, France
Lechien, Jérome ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage ; Université de Mons - UMONS > Faculté de Médecine et de Pharmacie > Service de Chirurgie
Ansarin, Mohssen; Department of Otorhinolaryngology-Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy
Atallah, Sarah; Department of Otorhinolaryngology-Head and Neck Surgery, Sorbonne University, Tenon Hospital, AP-HP, Paris, France
Barbut, Jonathan; Department of Otolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
Bizeau, Alain; Department of Otolaryngology and Head and Neck Surgery, Sainte Musse Hospital, Toulon, France
Burkey, Brian; Head & Neck Institute, Cleveland Clinic, Cleveland, OH, USA
Céruse, Philippe; Department of Otolaryngology-Head and Neck Surgery, Lyon-Nord Hospital, Lyon, France
Choussy, Olivier; Institut Curie Paris, Paris, France
Couineau, Florent; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France ; School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
De Mones Del Pujol, Erwan; Department of Otolaryngology-Head and Neck Surgery, Pellegrin Hospital, University Hospital, CHU Bordeaux, France
Dolivet, Gilles; Department of Otolaryngology-Head and Neck Surgery, Cancerology Institute of Lorraine, Nancy, France
Fakhry, Nicolas; Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, Marseille, France
Garrel, Renaud; ENT Department, Neck Surgery and Maxillofacial Surgery, Gui de Chauliac University Hospital, Montpellier University School of Medicine, Montpellier, France
Giger, Roland; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
Golusiński, Wojciech; Department of Head and Neck Surgery, Poznan University of Medical Sciences and The Greater Poland Cancer Centre, Poznan, Poland
Gorphe, Philippe; Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, Villejuif, France
Lorentz, Clémence; Pasteur Kleber Health Center, Essey-les-Nancy, France
Malard, Olivier; Department of Otolaryngology Head and Neck Surgery, Nantes University Hospital, Nantes, France
Meccariello, Giuseppe; Department of Surgery, Otolaryngology, Head-Neck Surgery Unit, Morgagni Pierantoni Hospital, 47121, Forlì, Italy
Morinière, Sylvain; Otorhinolaryngology Department, CHU Bretonneau, François Rabelais University, Tours, France
Pellini, Raul; Department of Otolaryngology, Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, 00144, Rome, Italy
Saroul, Nicolas; Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital Center Gabriel Montpied, Clermont-Ferrand, France
Tagliabue, Marta; Department of Otorhinolaryngology-Head and Neck Surgery, European Institute of Oncology, IRCCS, Milan, Italy
Vergez, Sebastien; Department of Head and Neck Surgery, University Hospital of Toulouse Larrey & Oncopole, Toulouse, France
Vilaseca, Isabel; Otorhinolaryngology Head-Neck Surgery Department, Hospital Clínic, IDIBAPS Universitat de Barcelona, Barcelona, Spain
Villeneuve, Alexandre; Department of ENT Head and Neck Surgery, Percy Military Training Hospital, Clamart, France
Baudouin, Robin ; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France. r.baudouin@hopital-foch.com ; School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France. r.baudouin@hopital-foch.com
F. Bray M. Laversanne H. Sung et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries CA Cancer J Clin 2024 10.3322/caac.21834 38572751
Y.M. Park H.K. Byeon H.P. Chung et al. Comparison of treatment outcomes after transoral robotic surgery and supraglottic partial laryngectomy: our experience with seventeen and seventeen patients respectively Clin Otolaryngol 2013 38 270 274 1:STN:280:DC%2BC3svhsVKitQ%3D%3D 10.1111/coa.12101 23441587
G. Peretti C. Piazza M. Ansarin et al. Transoral CO2 laser microsurgery for Tis-T3 supraglottic squamous cell carcinomas Eur Arch Otorhinolaryngol 2010 267 1735 1742 10.1007/s00405-010-1284-1 20499077
G. Peretti C. Piazza A. Cattaneo et al. Comparison of functional outcomes after endoscopic versus open-neck supraglottic laryngectomies Ann Otol Rhinol Laryngol 2006 115 827 832 10.1177/000348940611501106 17165665
P. Ambrosch M. Gonzalez-Donate A. Fazel et al. Transoral laser microsurgery for supraglottic cancer Front Oncol 2018 8 158 10.3389/fonc.2018.00158 29868479 5954241
V. Razafindranaly B. Lallemant K. Aubry et al. Clinical outcomes with transoral robotic surgery for supraglottic squamous cell carcinoma: experience of a French evaluation cooperative subgroup of GETTEC Head Neck 2016 38 E1097 E1101 10.1002/hed.24163 26435046
M. Ansarin S. Zorzi M.A. Massaro et al. Transoral robotic surgery vs transoral laser microsurgery for resection of supraglottic cancer: a pilot surgery Int J Med Robot Comput Assist Surg MRCAS 2014 10 107 112 10.1002/rcs.1546
M.R. Papazian M.S. Chow A.S. Jacobson et al. Role of transoral robotic surgery in surgical treatment of early-stage supraglottic larynx carcinoma Head Neck 2023 45 972 982 10.1002/hed.27325 36825894
Web of Science: h-index information. https://support.clarivate.com/ScientificandAcademicResearch/s/article/Web-of-Science-h-index-information?language=en_US. Accessed 10 Aug 2024
J.R. Lechien N. Fakhry S. Saussez et al. Surgical, clinical and functional outcomes of transoral robotic surgery for supraglottic laryngeal cancers: A systematic review Oral Oncol 2020 109 10.1016/j.oraloncology.2020.104848 32534362
S. Hans Y. Chekkoury-Idrissi M.P. Circiu et al. Surgical, oncological, and functional outcomes of transoral robotic supraglottic laryngectomy Laryngoscope 2021 131 1060 1065 10.1002/lary.28926 32812245
L. Ottenstein H. Cornett J.M. Switchenko et al. Characterizing postoperative physiologic swallow function following transoral robotic surgery for early stage tonsil, base of tongue, and unknown primary human papillomavirus-associated squamous cell carcinoma Head Neck 2021 43 1629 1640 10.1002/hed.26632 33547716
M. Dombrée R. Crott G. Lawson et al. Cost comparison of open approach, transoral laser microsurgery and transoral robotic surgery for partial and total laryngectomies Eur Arch Otorhinolaryngol 2014 271 2825 2834 10.1007/s00405-014-3056-9 24906840
Albergotti WG, Gooding WE, Kubik MW, et al (2017) Assessment of surgical learning curves in transoral robotic surgery for squamous cell carcinoma of the oropharynx. JAMA Otolaryngol-Head Neck Surg 143: 542–548. https://doi.org/10.1001/jamaoto.2016.4132
S. Hans C. Badoual P. Gorphe D. Brasnu Transoral robotic surgery for head and neck carcinomas Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 2012 269 1979 1984 10.1007/s00405-011-1865-7
M. Bernal-Sprekelsen J.-L. Blanch M. Caballero-Borrego I. Vilaseca The learning curve in transoral laser microsurgery for malignant tumors of the larynx and hypopharynx: parameters for a levelled surgical approach Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 2013 270 623 628 10.1007/s00405-012-2181-6
P. Bradley The learning curve in the use of trans-oral laser microsurgery for cancer treatment Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 2013 270 1967 1968 10.1007/s00405-013-2357-8
J.R. Lechien L. Haddad F.C. Holsinger et al. Adoption of otolaryngologist-head neck surgeons toward transoral robotic surgery: an international survey Laryngosc Investig Otolaryngol 2022 8 95 102 10.1002/lio2.1003
M. Remacle A. Hantzakos H. Eckel et al. Endoscopic supraglottic laryngectomy: a proposal for a classification by the working committee on nomenclature, European Laryngological Society Eur Arch Oto-Rhino-Laryngol Off J Eur Fed Oto-Rhino-Laryngol Soc EUFOS Affil Ger Soc Oto-Rhino-Laryngol - Head Neck Surg 2009 266 993 998 10.1007/s00405-008-0901-8
W.M. Mendenhall J.T. Parsons A.A. Mancuso et al. Radiotherapy for squamous cell carcinoma of the supraglottic larynx: An alternative to surgery Head Neck 1996 18 24 35 1:STN:280:DyaK28zntFSrtg%3D%3D 10.1002/(SICI)1097-0347(199601/02)18:1<24::AID-HED4>3.0.CO;2-0 8774919
C. Zhan X. Yang X. Song L. Yan Radiotherapy vs surgery for T1–2N0M0 laryngeal squamous cell carcinoma: a population-based and propensity score matching study Cancer Med 2018 7 2837 2847 10.1002/cam4.1525 29733513 6051150
A.S. Jones B. Fish J.E. Fenton D.J. Husband The treatment of early laryngeal cancers (T1–T2 N0): surgery or irradiation? Head Neck 2004 26 127 135 10.1002/hed.10361 14762881
Y.I. More T.T. Tsue D.A. Girod et al. Functional swallowing outcomes following transoral robotic surgery vs primary chemoradiotherapy in patients with advanced-stage oropharynx and supraglottis cancers JAMA Otolaryngol Neck Surg 2013 139 43 48 10.1001/jamaoto.2013.1074
C. Orús X. León M. Vega M. Quer Initial treatment of the early stages (I, II) of supraglottic squamous cell carcinoma: partial laryngectomy versus radiotherapy Eur Arch Otorhinolaryngol 2000 257 512 516 10.1007/s004050000276 11131380
P. Gorphe A contemporary review of evidence for transoral robotic surgery in laryngeal cancer Front Oncol 2018 8 121 10.3389/fonc.2018.00121 29721446 5915483
M.T. Turner W.A. Stokes C.M. Stokes et al. Airway and bleeding complications of transoral robotic supraglottic laryngectomy (TORS-SGL): a systematic review and meta-analysis Oral Oncol 2021 118 10.1016/j.oraloncology.2021.105301 33940531
