Robotic compared with open operations for cancers of the head and neck: a systematic review and meta-analysis

Publication date: Available online 13 September 2019Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): H. Liu, Y. Wang, C. Wu, X. Sun, L. Li, C. Li, Q. Chen, E. LuoAbstractTo compare the effectiveness and safety of robotic surgery with that of open operations for patients with cancers of the head and neck we made an electronic search of the CENTRAL, MEDLINE, EMBASE, CNKI, CBM, Opengray and Sciencepaper Online databases, and then made a manual search of specific online databases and the reference lists of relevant papers. Our most recent searches were made on 18 July 2018, and we included randomised controlled trials (RCT), case-control studies, cohort studies, and cross-sectional surveys in which robotic was compared with open surgery for cancer of the head and neck. Data from all the studies included were extracted by two independent workers. The risk ratio was chosen to measure dichotomous effects of treatment for prospective studies including RCT or cohort studies, while the odds ratio was chosen for case-control or cross-sectional studies. The weighted mean difference or standard mean difference was chosen to summarise continuous effects. A random-effects model was used for all data analyses. Thirteen studies were included: one RCT, nine cohort studies, and three cross-sectional studies. Robotic surgery was associated with fewer invaded resection margins, lower recurrence, less need for intraoperative tracheostomy, and less need and shorter duration of po...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research

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Publication date: Available online 25 July 2019Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): D. Tighe, I. Sassoon, A. Hills, R. QuadrosAbstractPatients treated surgically for squamous cell carcinoma (SCC) of the head and neck form a heterogeneous group, and it is difficult to take this variation into account when measuring the quality of care. We have tested the feasibility of mathematical models that allow for the adjustment for case mix when auditing the length of hospital stay as a proxy indicator of the quality of care. We completed a case-note audit of 733 surgical episodes of care for SCC of the...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Overnight intubation, which avoids the need for tracheostomy in patients who have operations for cancer of the head and neck, has increased in popularity in the United Kingdom since initial reports of the Gloucester experience in the British Journal of Oral and Maxillofacial Surgery.1 We have adopted overnight intubation as part of an improved recovery protocol in our own unit, with positive results.
Source: The British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: Technical note Source Type: research
ConclusionNasotracheal intubation using fiberoptic bronchoscopy is the most preferred technique for the management of a difficult airway. Efficient airway management during the perioperative period significantly reduces the post-operative length of hospital stay and morbidity.
Source: Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Conclusions In the span of a very short time—less than a decade—robotic head and neck surgery has transformed the management of the head and neck cancer, and it seems clear that the future of treatment for these cancers lies in a multimodal approach in which TORS is likely to play an important role. Nevertheless, it is important to keep in mind that the current indications for TORS are limited and long-term data on the safety and oncological outcomes are needed to better understand the true role of TORS in treatment of head and neck cancer. Nonetheless, the emergence of ever more advanced robotic instruments i...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: The performance of AS AC generally increased as the population of the atlas library increased. However, the performance does not drastically vary in the larger atlas libraries in contrast to the logic that bigger atlas library should lead to better results. In fact, the results do not vary significantly toward the larger atlas library. It is necessary for the institutions to independently research the optimal number of subjects. Introduction Manual contouring of target and critical structures is resource intensive aspect of the radiotherapy planning process. In order to reduce time and workload imposed o...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractTracheostomy is a life-saving procedure done electively or most commonly in emergency basis. In patients with diagnosed case of cancer in upper airway tract they usually require tracheostomy at some point of time during their whole treatment procedure. Patients receiving radiotherapy or chemotherapy or combination of these are at high risk of developing post treatment changes in neck anatomy. Redo tracheostomy due to any reasons in such types of patients is a surgical challenge. The purpose of this article is to share our surgical technique in redo tracheostomy. During a period of two years 39 patients with diagnos...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research
Introduction: Communication after microvacular reconstruction of the head and neck for oral and oropharyngeal carcinoma is difficult, and the peri-operative period frequently necessitates a tracheostomy. Publications have demonstrated that this is a fearful time for patients with feelings of frustration, powerless, to concerns arising in an emergency situation. Our hypothesis was that by aiding communication utilising a touch screen tablet device (Apple iPad ®) that patient satisfaction with communication would increase.
Source: The British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: P131 Source Type: research
Publication date: Available online 4 October 2018Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): R. Smirk, P. KyzasAbstractDespite advances in the primary treatment of oral and oropharyngeal cancer, many patients develop local or regional recurrence, or both, and when radiotherapy has already been used, operation provides the best chance of salvage for these patients. We have looked at the outcomes of salvage procedures in a single unit, including improved survival, morbidity, and treatment-related quality of life. Patients treated with salvage procedures were identified from a prospectively-completed d...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
Conclusion-clinical relevanceFree flap reconstruction is a safe and reliable technique with head and neck cancer reconstruction. Postoperative care favouring early and safe oral-feeding, and avoiding a tracheostomy can reduce the incidence of surgical complications after OSCC reconstruction.
Source: Clinical Oral Investigations - Category: Dentistry Source Type: research
Publication date: Available online 17 August 2018Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): H. Mohamedbhai, S. Ali, I. Dimasi, N. KalavrezosAbstractOur aim was to provide a simple and effective scoring system to guide decision making in management of the airway. We retrospectively reviewed the casenotes of all patients diagnosed with head and neck cancer and who were treated by resection with primary flap reconstruction. Those factors that were significant (p
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
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