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ANZ J Surg. 2018 Nov;88(11):1129-1134. doi: 10.1111/ans.13801. Epub 2016 Oct 21.

Transoral robotic surgery: implementation as a tool in head and neck surgery - a single-centre Australian experience.

Author information

1
Division of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
2
Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
3
Department of Surgery, The University of Melbourne, Melbourne, Victoria, Australia.

Abstract

BACKGROUND:

Transoral robotic surgery (TORS) is now a well-validated technique for resection of head and neck cancers. Benefits include reduced patient morbidity, swallowing preservation and rationalization of adjuvant therapies.

METHODS:

This was a single-centre, retrospective review of 35 patients who underwent TORS of oro-, retro- and parapharyngeal tumours between March 2014 and August 2015. Outcome measures included resection margins, swallowing function and impact on post-operative radiotherapy.

RESULTS:

Median age was 63.7 years and the number of male patients was 22 (62.9%). Tongue base was the most common site (51.4%), followed by tonsil (25.7%). Nine patients (25.7%) had previous radiotherapy. A total of 24 patients had squamous cell carcinoma and the clear margin rate for primary TORS was 93.3%. Median hospital stay was 5.5 days, longer for previously irradiated patients (9 days). Median nasogastric tube dependence was 3.5 days. Four patients (11.4%) received a gastrostomy and two patients remained dependent on the tube at the time of last review. There were two major complications (5.7%): bleeding requiring return to theatre (1) and pulmonary embolism (1). Post-operative radiotherapy was either avoided or reduced in 22 patients (81.5%).

CONCLUSION:

TORS is a safe and effective tool, providing surgical access to oropharyngeal and other difficult to access areas. Patient selection and a multidisciplinary approach are essential to ensure adequate margins can be achieved and therefore to reduce adjuvant therapies.

KEYWORDS:

head and neck; salvage; squamous cell carcinoma; transoral robotic surgery

PMID:
27766718
DOI:
10.1111/ans.13801
[Indexed for MEDLINE]

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