Transoral laser surgery for the upper aerodigestive tract: A. C. Camargo Hospital initial experience

ABSTRACT

Background: Endoscopic laser surgery has been presented as a viable option for head and neck tumor resection. Among itsadvantages we may include fewer complication rates, shorter hospital stay and similar oncological results in selected caseswhen compared to conventional therapy. Objective: The aim of this report the initial experience of our service with endoscopiclaser surgery in head and neck. Patients and Methods: From June, 2002 to October, 2003, 55 patients underwent transorallaser surgery. They were 9 females and 46 males. The most common site was the glottis, accounting for 38 patients (69.1%),followed by oral cavity and oropharynx, 7 patients (12.7%); the supra-glottis, 5 patients (9.1%) and hypopharynx, 5 patients(9.1%). Forty-nine patients (89.1%) had just one surgical procedure, while the other six had between two and five surgicalprocedures. Results: Twenty-six patients presented malignant tumours, the most common histological type was squamous cellcarcinoma (24 patients). Four were submitted to simultaneous neck dissection. Twelve patients (21.8%) required a tracheotomyand five (9.1%) a feeding tube, due to the surgical procedure. In patients without malignant lesions, the most common werepapillomas, 6 cases (20.7%), followed by vocal cord hyperplasia in 4 patients (13, 8%). Other diagnoses were pharyngealstenosis, benign tumors, vocal cord cysts or nodules and vocal palsy. The complications rate in our series for transoral lasersurgery was 14.5%. The most common complications were post-operative symptomatic aspiration and bleeding in threepatients each (5.5%). Conclusions: Transoral laser resection is an effective procedure that has becoming widely accepted asa therapy of choice for selected head and neck neoplasms, mainly due its advantages over the conventional therapy whichinclude fewer complication rates, avoidance of tracheotomy and shorter hospital stay.