Indications and Clinical Outcomes of Transoral Robotic Surgery and Free Flap Reconstruction

We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of...

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Bibliographic Details
Published in:Cancers 2021-06, Vol.13 (11), p.2831
Main Authors: Gorphe, Philippe, Temam, Stéphane, Moya-Plana, Antoine, Leymarie, Nicolas, Kolb, Frédéric, Bout-Roumazeilles, Apolline, Qassemyar, Quentin, Benmoussa, Nadia, Honart, Jean-François
Format: Article
Language:English
Subjects:
Cancer
Chemoradiotherapy
Clinical outcomes
Defects
Endoscopy
FDA approval
Life Sciences
Microvasculature
Ostomy
Palate
Patients
Pharynx
Quality of life
Radiation therapy
Robotic surgery
Surgery
Sutures
Tongue
Tonsil
Tracheostomy
Tumors
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Summary:We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of the resection, and the transoral exposure of critical structures. We reviewed surgical data, postoperative complications, and functional outcomes comprising tracheostomy and alimentation management. Indications were upfront surgery (34%), a second primary surgery after radiotherapy (28%), or salvage surgery after chemoradiotherapy failure (38%). Localizations were the tongue base (44%), tonsillar fossa (28%), pharyngeal wall (22%), and soft palate (6%). T-classifications were T1 (6%), T2 (52%), T3 (20%), and T4 (22%). The mean length of the surgery was 574 min. Two patients were intraoperatively converted to a conventional approach at the beginning of the learning curve. In conclusion, TORS and free flap reconstruction in complex situations were associated with low rates of postoperative complications and satisfactory functional outcomes. They were, however, associated with a renewed learning curve.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers13112831