What´s new in PubMed this week
Expert Working Group on Thyroid Surgery, Chinese Medical Doctor Association Division of Surgeons; Thyroid Disease Committee of Chinese Research Hospital Association; General Surgery Branch of China International Exchange and Promotive Association for Medical and Health Care. [Clinical practice guideline for robotic surgical system-assisted thyroid and parathyroid surgery (2024 edition)]. Zhonghua Wai Ke Za Zhi. 2024 Aug 2;62(9):805-817. Chinese. doi: 10.3760/cma.j.cn112139-20240608-00285. Epub ahead of print. PMID: 39090058.
In year 2016, the American Thyroid Association (ATA) published a Consensus Statement on Remote-Access Thyroid Surgery. The document was already out-dated when it was published and it stated a timid approach to procedures that were already usual practice is places of the world different from the US, with series of thousands of patients.
The situation has not changed too much much in the western word, but is moving forward quite fast in the east. You can read this Chinese guideline in this link. How was it? Try Google translator. But be aware the there is a growing number of indexed papers in Chinese (just in Chinese, with no English translation).
Dietz A, Pirlich M, Stöhr M, Zebralla V, Wiegand S. Chirurgische Therapie des Oropharynxkarzinoms: Empfehlungen der aktuellen S3-Leitlinie – Teil I [Surgical Treatment of Oropharyngeal Cancer – Recommendations of the Current German S3 Guideline, Part I]. Laryngorhinootologie. 2024 Aug;103(8):599-612. German. doi: 10.1055/a-2223-4083. Epub 2024 Aug 1. PMID: 39089244.
A German guideline for the management of Oropharyngeal Cancer. Even the most cautious underline the primary role of surgery. But do not forget the discussion on constructing evidence on the management of oropharyngeal cancer.
Sampieri C, Cioccoloni E, Costantino A, Kim D, Lee K, Meccariello G, Cammaroto G, Vicini C, Kim SH. Neoadjuvant chemotherapy followed by transoral robotic surgery versus upfront surgery for locoregionally advanced oropharyngeal carcinoma: A propensity score matched analysis. Head Neck. 2024 Aug 1. doi: 10.1002/hed.27904. Epub ahead of print. PMID: 39087607.
I have previously raised my concern on using neoadjuvant chemotherapy for early stage oropharyngeal Cancer. This is a different situation.
Conclusions: “NAC followed by TORS for locoregionally advanced OPSCC demonstrated to achieve non-inferior survival outcomes to upfront surgery, while in the p16-positive population allowed to significantly spare adjuvant therapy”.
Louerat S, Hans S, Laroche S, Hyvrard C, Baudouin R. World premiere: transoral robot-assisted excision for nasopharyngeal ectopic pituitary adenoma. Eur Arch Otorhinolaryngol. 2024 Jul 31. doi: 10.1007/s00405-024-08850-3. Epub ahead of print. PMID: 39083058.
A TORS case report.
Chiari F, Guarino P, Di Martino G, Caporale CD, Presutti L, Molteni G. Features related to temporary tracheotomy in patients undergoing Transoral Robotic Surgery (TORS) for supraglottic squamous cell cancer of the larynx: A systematic review. Am J Otolaryngol. 2024 Jul 25;45(5):104436. doi: 10.1016/j.amjoto.2024.104436. Epub ahead of print. PMID: 39068815.
When to perform a prophylactic (safety) trach in (minimally invasive) supraglottic laryngectomy is usually a Surgeon / Center decision. But it a dilemma that is always on the surgeon´s mind.
No one likes to consider a trach in an otherwise minimally invasive procedure. But post-op bleeding might happen and a trach might be the difference between life and death. Although it should be adapted to the particular circumstances of every Center, a guideline of this topic might be useful.
Park D, Cho H, Lee E, Oh MY, Kim K, Chai YJ, Kim HY. Feasibility and Safety of transoral robotic parathyroidectomy: Initial experience with a new approach for parathyroid surgery. Asian J Surg. 2024 Jul 26:S1015-9584(24)01535-5. doi: 10.1016/j.asjsur.2024.07.162. Epub ahead of print. PMID: 39068075.
Thirteen patients (October 2016 to July 2019). No complications. All of the procedures were successful. Open access paper.
J Granell. August 3, 2024.