Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review
Objective This review assesses the effect on intra- and postoperative patient outcomes of the timing of neck dissection in relation to transoral surgery. Outcome measures include postoperative bleeding, intra- and postoperative fistula formation, and disease-specific and overall survival. Data Sourc...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | OTO Open |
| Online Access: | https://doi.org/10.1177/2473974X221131513 |
| _version_ | 1797641911855480832 |
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| author | Jai Parkash Ramchandani BSc Aina Brunet FEBEORL-HNS, PhD Nikoleta Skalidi FRCS Jack Faulkner MBBS Aleix Rovira MD, PhD, FEBORL-HNS Ricard Simo LMS, FRCS Jean-Pierre Jeannon MBChB, FRCS Asit Arora MBChB, PhD, FRCS |
| author_facet | Jai Parkash Ramchandani BSc Aina Brunet FEBEORL-HNS, PhD Nikoleta Skalidi FRCS Jack Faulkner MBBS Aleix Rovira MD, PhD, FEBORL-HNS Ricard Simo LMS, FRCS Jean-Pierre Jeannon MBChB, FRCS Asit Arora MBChB, PhD, FRCS |
| author_sort | Jai Parkash Ramchandani BSc |
| collection | DOAJ |
| description | Objective This review assesses the effect on intra- and postoperative patient outcomes of the timing of neck dissection in relation to transoral surgery. Outcome measures include postoperative bleeding, intra- and postoperative fistula formation, and disease-specific and overall survival. Data Sources A search was conducted across the MEDLINE, Embase, US National Library of Medicine, and Cochrane databases with search terms in July 2021. Review Methods Articles that conformed with specified inclusion criteria were included. Included articles were scanned for bias with the ROBINS-I tool. Results Nineteen articles were selected for qualitative analysis, including 546 patients who had neck dissection in conjunction with transoral robotic surgery/transoral laser microsurgery (TORS/TLM). Seventy-one (18%) patients had neck dissection prior to TORS/TLM, 39 (10%) had neck dissection performed after TORS/TLM, and 281 (72%) had concurrent procedures. In patients with neck dissection before TORS/TLM, 3% experienced major postoperative bleeding, and fistula rates were 0%. In the cohort with neck dissection after TORS/TLM, 3% experienced minor postoperative hemorrhage, and 8% had intraoperative fistulae. In the concurrent cohort of patients, 1% had major postoperative bleeds and 0.3% had minor bleeds, while 4% developed intraoperative fistulas and 0.3% developed postoperative fistulas. Conclusion Current evidence indicated that there appears to be no correlation between timing of neck dissection and complications. This systematic review found insufficient data to comment on whether the timing of neck dissection in relation to TORS/TLM affects the outcomes of patients. |
| first_indexed | 2024-03-11T13:52:32Z |
| format | Article |
| id | doaj.art-9cc4fd4150d6483f91728339ba0bdbdf |
| institution | Directory Open Access Journal |
| issn | 2473-974X |
| language | English |
| last_indexed | 2024-03-11T13:52:32Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | OTO Open |
| spelling | doaj.art-9cc4fd4150d6483f91728339ba0bdbdf2023-11-02T08:09:39ZengWileyOTO Open2473-974X2022-10-01610.1177/2473974X221131513Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic ReviewJai Parkash Ramchandani BSc0Aina Brunet FEBEORL-HNS, PhD1Nikoleta Skalidi FRCS2Jack Faulkner MBBS3Aleix Rovira MD, PhD, FEBORL-HNS4Ricard Simo LMS, FRCS5Jean-Pierre Jeannon MBChB, FRCS6Asit Arora MBChB, PhD, FRCS7King’s College London, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandDepartment of Otorhinolaryngology and Head and Neck Surgery, Guy’s and St Thomas NHS Foundation Trust, London, EnglandObjective This review assesses the effect on intra- and postoperative patient outcomes of the timing of neck dissection in relation to transoral surgery. Outcome measures include postoperative bleeding, intra- and postoperative fistula formation, and disease-specific and overall survival. Data Sources A search was conducted across the MEDLINE, Embase, US National Library of Medicine, and Cochrane databases with search terms in July 2021. Review Methods Articles that conformed with specified inclusion criteria were included. Included articles were scanned for bias with the ROBINS-I tool. Results Nineteen articles were selected for qualitative analysis, including 546 patients who had neck dissection in conjunction with transoral robotic surgery/transoral laser microsurgery (TORS/TLM). Seventy-one (18%) patients had neck dissection prior to TORS/TLM, 39 (10%) had neck dissection performed after TORS/TLM, and 281 (72%) had concurrent procedures. In patients with neck dissection before TORS/TLM, 3% experienced major postoperative bleeding, and fistula rates were 0%. In the cohort with neck dissection after TORS/TLM, 3% experienced minor postoperative hemorrhage, and 8% had intraoperative fistulae. In the concurrent cohort of patients, 1% had major postoperative bleeds and 0.3% had minor bleeds, while 4% developed intraoperative fistulas and 0.3% developed postoperative fistulas. Conclusion Current evidence indicated that there appears to be no correlation between timing of neck dissection and complications. This systematic review found insufficient data to comment on whether the timing of neck dissection in relation to TORS/TLM affects the outcomes of patients.https://doi.org/10.1177/2473974X221131513 |
| spellingShingle | Jai Parkash Ramchandani BSc Aina Brunet FEBEORL-HNS, PhD Nikoleta Skalidi FRCS Jack Faulkner MBBS Aleix Rovira MD, PhD, FEBORL-HNS Ricard Simo LMS, FRCS Jean-Pierre Jeannon MBChB, FRCS Asit Arora MBChB, PhD, FRCS Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review OTO Open |
| title | Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review |
| title_full | Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review |
| title_fullStr | Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review |
| title_full_unstemmed | Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review |
| title_short | Neck Dissection Timing in Transoral Robotic or Laser Microsurgery in Oropharyngeal Cancer: A Systematic Review |
| title_sort | neck dissection timing in transoral robotic or laser microsurgery in oropharyngeal cancer a systematic review |
| url | https://doi.org/10.1177/2473974X221131513 |
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