Minimally invasive selective neck dissection: a prospective study of endoscopically assisted dissection via a small submandibular approach in cT1-2N0 oral squamous cell carcinoma

Abstract

Abstract: PURPOSE: Selective neck dissection(SND) in clinical N0 (cN0) cases of oral squamous cell carcinoma 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: Fifty-four patients with cT1-2N0 oral squamous cell carcinoma(OSCC) were randomly divided into 2 groups of endoscopically assisted SND and conventional SND. Perioperative and postoperative outcomes of the 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 (124.04±13.47 min) was longer than that in the conventional group(73.47±15.36 min). However, the mean length of the incision was （4.23±0.56） 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 which provided minimal invasiveness and satisfactory appearance.

Key words: Minimal invasion, Endoscopically assisted Surgery, Selective neck dissection, Submandibular approach, Oral squamous cell carcinoma

CLC Number:

R739.85

FAN Song, YANG Zhao-hui, YE Jian-tao, CHEN Wei-liang, WANG You-yuan, ZHANG Da-ming, LIN Zhao-yu, ZHOU Bin, LIANG Qi-xiang, HUANG Xiao-ming, LI Jin-song. Minimally invasive selective neck dissection: a prospective study of endoscopically assisted dissection via a small submandibular approach in cT1-2N0 oral squamous cell carcinoma[J]. China Journal of Oral and Maxillofacial Surgery, 2015, 13(3): 232-239.

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