Torosyan Yu.A., Shevalgin A.A., Reshetov I.V., Polunin G.V., Istranov A.L., Ilyasova D.B., Kiseleva A.E., Rostislavova E.A., Komissarova M.V., Sukortseva N.S. Robot-Assisted Neck Lymphadenectomy Through a Retroauricular-Posterior Cervical Approach. Head and neck. Head and Neck. Russian Journal. 2025;13(4):89–94
DOI: https://doi.org/10.25792/HN.2025.13.4.89-94
Objective. To evaluate the surgical and oncological outcomes of robot-assisted neck lymphadenectomy performed through a retroauricular-posterior cervical approach compared with conventional open neck lymphadenectomy via an anterolateral cervical incision in patients with head and neck malignancies.
Material and methods. A prospective single-center comparative study was conducted from January 2022 to December 2024 and included 58 patients with histologically confirmed head and neck cancers. Patients were divided into two equal groups: conventional open neck lymphadenectomy (n=29) and robot-assisted lymphadenectomy performed through a retroauricular-posterior cervical approach (n=29). The following parameters were analyzed: operative time, intraoperative blood loss, postoperative complications according to the Clavien-Dindo classification, length of hospital stay, and disease-free survival at 12 and 24 months.
Results. Robot-assisted lymphadenectomy was associated with longer operative time (120±25 vs. 100±20 minutes; p<0.01), but significantly reduced blood loss (50±15 vs. 150±30 mL; p<0.001). The incidence of Clavien–Dindo grade I-II complications was lower in the robotic group (4.8% vs. 27.6%; p<0.05), and no grade III-V complications were observed. Hospital stay was shorter after robotic surgery (5±1 vs. 7±1 days; p<0.001). Disease-free survival at 12 and 24 months did not significantly differ between the groups (p>0.05).
Conclusion. Robot-assisted neck lymphadenectomy through a retroauricular-posterior cervical approach provides oncological radicality comparable to the traditional open technique while significantly reducing operative trauma and postoperative complications. Further studies are required to clarify long-term oncological outcomes, refine patient selection criteria, and expand the clinical application of this technology in head and neck oncologic surgery.
Keywords: robot-assisted surgery; neck lymphadenectomy; retroauricular-posterior cervical approach; head and neck oncology; minimally invasive surgery; cervical lymph nodes; da Vinci Si system; oncological radicality.
Conflict of interest. The authors declare that they have no conflict of interest.
Funding. This study required no funding