Top

Published in:

01-11-2014 | Head and Neck Oncology

Minimally Invasive Selective Neck Dissection: A Prospective Study of Endoscopically Assisted Dissection via a Small Submandibular Approach in cT_1–2N₀ Oral Squamous Cell Carcinoma

Authors: Song Fan, MD, Fa-Ya Liang, MD, Wei-Liang Chen, MD, Zhao-Hui Yang, MD, PhD, Xiao-Ming Huang, MD, PhD, You-Yuan Wang, MD, Zhao-Yu Lin, MD, Da-Ming Zhang, MD, Bin Zhou, MD, Wei-Xiong Chen, MD, Qiang Chai, MD, Hui-Jin Wang, MD, Chao-Bin Pan, MD, PhD, Qi-Xiang Liang, MD, Xin Yu, MD, Eduardo Dias-Ribeiro, DDS, MSc, Yu-Huan Feng, MD, Jin-Song Li, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2014

Abstract

Background

Selective neck dissection (SND) in clinical N₀ (cN₀) cases of oral squamous cell carcinoma (SCC) has been performed by surgeons using a retroauricular or modified facelift approach with robotic or endoscopic assistance. However, these procedures provide cosmetic satisfaction at the cost of possible maximal invasiveness. In this prospective study, we introduced and evaluated the feasibility as well as surgical invasiveness and cosmetic outcome of endoscopically-assisted SND via a small submandibular approach.

Methods

Forty-four patients with cT_1–2N₀ oral SCC (OSCC) were randomly divided into two groups of endoscopically-assisted SND and conventional SND. Perioperative and postoperative outcomes of patients were evaluated, including the length of the incision, operating time for neck dissection, estimated blood loss during the operation, amount and duration of drainage, total hospitalization period, total number of lymph nodes retrieved, satisfaction scores based on the cosmetic results, perioperative local complications, shoulder syndrome, and follow-up information.

Results

The mean operation time in the endoscopically-assisted group (126.04 ± 12.67 min) was longer than that in the conventional group (75.67 ± 16.67 min). However, the mean length of the incision was 4.33 ± 0.76 cm in the endoscopically-assisted SND group, and the amount and duration of drainage, total hospital stay, postoperative shoulder pain score, and cosmetic outcomes were superior in the endoscopically-assisted SND group. Additionally, the retrieved lymph nodes and complications were comparable.

Conclusions

Endoscopically-assisted SND via a small submandibular approach had a longer operation time than the conventional approach. However, endoscopically-assisted SND was feasible and reliable while providing minimal invasiveness and satisfactory appearance.

Available only for authorised users

Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0. Cancer incidence and mortality worldwide: IARC Cancer Base No. 11. Lyon: International Agency for Research on Cancer. Available from: http://globocan.iarc.fr. 2013. Accessed 1 Nov 2013.

Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63(1):11–30.PubMedCrossRef

Fan S, Tang QL, Lin YJ, et al. A review of clinical and histological parameters associated with contralateral neck metastases in oral squamous cell carcinoma. Int J Oral Sci. 2011;3(4):180–191.PubMedCrossRefPubMedCentral

Ferlito A, Rinaldo A, Silver CE, et al. Elective and therapeutic selective neck dissection. Oral Oncol. 2006;42(1):14–25.PubMedCrossRef

Pitman KT. Rationale for elective neck dissection. Am J Otolaryngol. 2000;21:31–7.PubMedCrossRef

Ketchum LD, Cohen IK, Masters FW. Hypertrophic scars and keloids: a collective review. Plast Reconstr Surg. 1974;53:140–154.PubMedCrossRef

Muenscher A, Dalchow C, Kutta H, Knecht R. The endoscopic approach to the neck: a review of the literature, and overview of the various techniques. Surg Endosc. 2011;25(5):1358–63.PubMedCrossRef

Brunt LM, Jones DB, Wu JS, Quasebarth MA, Meininger T, Soper NJ. Experimental development of an endoscopic approach to neck exploration and parathyroidectomy. Surgery. 1997;122:893–901.PubMedCrossRef

Gagner M. Endoscopic subtotal parathyroidectomy in patients with primary hyperparathyroidism. Br J Surg. 1996;83:875.PubMedCrossRef

10.

Lee D, Nam Y, Sung K. Single-incision endoscopic thyroidectomy by the axillary approach. J Laparoendosc Adv Surg Tech A. 2010;20:839–842.PubMedCrossRef

11.

Byeon HK, Holsinger FC, Koh YW, et al. Endoscopic supraomohyoid neck dissection via a retroauricular or modified facelift approach: preliminary results. Head Neck. 2014;36(3):425–30.PubMedCrossRef

12.

Lee HS, Kim WS, Hong HJ, et al. 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. 2012;19(12):3871–8.PubMedCrossRef

13.

Kim WS, Lee HS, Kang SM, et al. Feasibility of robot-assisted neck dissections via a transaxillary and retroauricular (“TARA”) approach in head and neck cancer: preliminary results. Ann Surg Oncol. 2012;19(3):1009–17.PubMedCrossRef

14.

Tae K, Ji YB, Song CM, Min HJ, Kim KR, Park CW. Robotic selective neck dissection using a gasless postauricular facelift approach for early head and neck cancer: technical feasibility and safety. J Laparoendosc Adv Surg Tech A. 2013;23(3):240–5.PubMedCrossRef

15.

Kim CH, Koh YW, Kim D, Chang JW, Choi EC, Shin YS. Robotic-assisted neck dissection in submandibular gland cancer: preliminary report. J Oral Maxillofac Surg. 2013;71(8):1450–7.PubMedCrossRef

16.

Kim CH, Chang JW, Choi EC, Shin YS, Koh YW. Robotically assisted selective neck dissection in parotid gland cancer: preliminary report. Laryngoscope. 2013;123(3):646–50.PubMedCrossRef

17.

Oliveira CM, Nguyen HT, Ferraz AR, Watters K, Rosman B, Rahbar R. Robotic surgery in otolaryngology and head and neck surgery: a review. Minim Invasive Surg. 2012;2012:286563.PubMedPubMedCentral

18.

Tan CT, Cheah WK, Delbridge L. “Scarless” (in the neck) endoscopic thyroidectomy (SET): an evidence-based review of published techniques. World J Surg. 2008;32:1349–1357.PubMedCrossRef

19.

Murer K, Huber GF, Haile SR, Stoeckli SJ. Comparison of morbidity between sentinel node biopsy and elective neck dissection for treatment of the n0 neck in patients with oral squamous cell carcinoma. Head Neck. 2011;33(9):1260–4.PubMedCrossRef

20.

Fan S, Chen WL, Yang ZH, Huang ZQ. Comparison of the efficiencies of permanent maxillary tooth removal performed with single buccal infiltration versus routine buccal and palatal injection. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107(3):359–63.PubMedCrossRef

21.

Dhiman SV, Inabnet WB. Minimally invasive surgery for thyroid diseases and thyroid cancer. J Surg Oncol. 2008;97(8):665–8.PubMedCrossRef

22.

Shimizu K, Akira S, Jasmi AY, et al. Video-assisted neck surgery: endoscopic resection of thyroid tumors with a very minimal neck wound. J Am Coll Surg. 1999;188(6):697–703.PubMedCrossRef

23.

Melvin TA, Eliades SJ, Ha PK, et al. Neck dissection through a facelift incision. Laryngoscope. 2012;122(12):2700–6.PubMedCrossRefPubMedCentral

24.

Griffin JE, Jo C. Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature. J Oral Maxillofac Surg. 2007;65:2227–2234.PubMedCrossRef

25.

Chen WL, Zhang DM, Yang ZH, Wang YY, Fan S. Functional hemitongue reconstruction using innervated supraclavicular fasciocutaneous island flaps with the cervical plexus and reinnervated supraclavicular fasciocutaneous island flaps with neurorrhaphy of the cervical plexus and lingual nerve. Head Neck. 2014;36(1):66–70.PubMedCrossRef

26.

Rihani J, Lee MR, Lee T, Ducic Y. Flap selection and functional outcomes in total glossectomy with laryngeal preservation. Otolaryngol Head Neck Surg. 2013;149(4):547–53.PubMedCrossRef

Title: Minimally Invasive Selective Neck Dissection: A Prospective Study of Endoscopically Assisted Dissection via a Small Submandibular Approach in cT1–2N0 Oral Squamous Cell Carcinoma
Authors: Song Fan, MD
Fa-Ya Liang, MD
Wei-Liang Chen, MD
Zhao-Hui Yang, MD, PhD
Xiao-Ming Huang, MD, PhD
You-Yuan Wang, MD
Zhao-Yu Lin, MD
Da-Ming Zhang, MD
Bin Zhou, MD
Wei-Xiong Chen, MD
Qiang Chai, MD
Hui-Jin Wang, MD
Chao-Bin Pan, MD, PhD
Qi-Xiang Liang, MD
Xin Yu, MD
Eduardo Dias-Ribeiro, DDS, MSc
Yu-Huan Feng, MD
Jin-Song Li, MD, PhD
Publication date: 01-11-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 12/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3833-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Minimally Invasive Selective Neck Dissection: A Prospective Study of Endoscopically Assisted Dissection via a Small Submandibular Approach in cT_1–2N₀ Oral Squamous Cell Carcinoma

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 12/2014

Pure Laparoscopic Right Hepatectomy with␣the␣Hanging Maneuver for␣Multiple Hepatocellular Adenomas

Robotic Total Thyroidectomy with Modified Radical Neck Dissection via Unilateral Retroauricular Approach

Concomitant Seminal Vesicle Invasion in pT4a Urothelial Carcinoma of the Bladder with Contiguous Prostatic Infiltration is an Adverse Prognosticator for Cancer-Specific Survival after Radical Cystectomy

A Meta-Analysis to Determine the Effect of Primary Tumor Resection for Stage IV Colorectal Cancer with Unresectable Metastases on Patient Survival

Cost Effectiveness of Different Central Venous Approaches for Port Placement and Use in Adult Oncology Patients: Evidence From a Randomized Three-Arm Trial

The Importance of Surgical Volume on Outcomes in Thyroid Surgery Revisited: Old is in Again