Pull-through resection without free-flap reconstruction for lateral wall oropharyngeal cancer

Jpn J Clin Oncol. 2020 Sep 5;50(9):1018-1022. doi: 10.1093/jjco/hyaa079.

Abstract

Background: While transoral robotic surgery (TORS) is widely used for the management of lateral wall oropharyngeal carcinomas (OPC), open surgical techniques are still used in some cases. A pull-through method for open surgical resections of OPC has recently been introduced. We improved on this method by eliminating the need for subsequent free-flap reconstruction.

Methods: 16 patients with lateral wall OPC underwent pull-through resections. After resection, we used the digastric muscle, stylohyoid muscles, submandibular gland and the surrounding tissues to block the neck and oral cavity and to avoid reconstruction.

Results: This novel technique was performed without major complications or morbidities. The average post-operative hospital stay was 14.6 ± 6.1 days, and the average duration until initiation of oral intake post-operation was 6.5 ± 2.9 days. Oncological outcomes, post-operative course and function were acceptable.

Conclusions: Our novel method provides an efficient and less invasive surgical technique than conventional open approaches.

Keywords: lip-splitting; mandibular swing; oropharyngeal cancer; pull-through; reconstruction.

MeSH terms

  • Aged
  • Female
  • Free Tissue Flaps / surgery*
  • Humans
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / surgery*
  • Plastic Surgery Procedures / methods*
  • Robotic Surgical Procedures / methods*