Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach
Abstract Objective Transoral robotic surgery (TORS) has evolved since its 2009 US Food and Drug Administration approval for use in local stage T1–T2 oropharyngeal carcinoma. The ability to resect increasingly larger and more complex lesions has led to the need to introduce reconstructive techniques...
| Główni autorzy: | , , , , , , , , |
|---|---|
| Format: | Artykuł |
| Język: | English |
| Wydane: |
Wiley
2023-12-01
|
| Seria: | Laryngoscope Investigative Otolaryngology |
| Hasła przedmiotowe: | |
| Dostęp online: | https://doi.org/10.1002/lio2.1176 |
| _version_ | 1827578306615050240 |
|---|---|
| author | David Virós Porcuna Constanza Viña Soria Jordi Vila Poyatos Mar Palau Viarnès Paloma Malagon López Carlota Gonzàlez Lluch Carmen Higueras Suñe Carlos M. Pollán Guisasola Cristian Carrasco López |
| author_facet | David Virós Porcuna Constanza Viña Soria Jordi Vila Poyatos Mar Palau Viarnès Paloma Malagon López Carlota Gonzàlez Lluch Carmen Higueras Suñe Carlos M. Pollán Guisasola Cristian Carrasco López |
| author_sort | David Virós Porcuna |
| collection | DOAJ |
| description | Abstract Objective Transoral robotic surgery (TORS) has evolved since its 2009 US Food and Drug Administration approval for use in local stage T1–T2 oropharyngeal carcinoma. The ability to resect increasingly larger and more complex lesions has led to the need to introduce reconstructive techniques through this route, avoiding the classic transmandibular or pull‐through approach. Few studies have compared the safety, efficacy, and advantages of TORS versus classic open approaches in oropharyngeal salvage surgery with reconstruction using microanastomosed flaps. Here we retrospectively compare our center's experience with the open approach and TORS and describe the technical variations used. Methods Between 2013 and 2021, 30 stage III–IV oropharyngeal cancer patients underwent salvage surgery with reconstruction in our center. From 2013 to 2017, 15 patients underwent surgery with the classic open approach, and from 2018 to 2021, an additional 15 patients underwent TORS. We have compared surgical outcomes, post‐surgical results, and survival in the two groups. Results Patient characteristics were similar in the two groups. TORS was associated with shorter surgical time (p < .001), fewer complications (p = .01), shorter hospital stay (p < .001), and lower feeding tube requirements (p = .003). No significant differences were observed between the two groups in the free margin rate or survival. Conclusion Oropharyngeal salvage surgery with TORS with free flap reconstruction reduced associated morbidity compared to the open approach in a patient cohort with poor prognosis. Level of Evidence 4. |
| first_indexed | 2024-03-08T21:44:50Z |
| format | Article |
| id | doaj.art-3bc3333a862c4c0aabe027c23cfbfb64 |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-03-08T21:44:50Z |
| publishDate | 2023-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-3bc3333a862c4c0aabe027c23cfbfb642023-12-20T09:48:34ZengWileyLaryngoscope Investigative Otolaryngology2378-80382023-12-01861564157010.1002/lio2.1176Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approachDavid Virós Porcuna0Constanza Viña Soria1Jordi Vila Poyatos2Mar Palau Viarnès3Paloma Malagon López4Carlota Gonzàlez Lluch5Carmen Higueras Suñe6Carlos M. Pollán Guisasola7Cristian Carrasco López8Otolaryngology Section, Head and Neck Surgery Hospital Germans Trias i Pujol Badalona SpainOtolaryngology Section, Head and Neck Surgery Hospital Germans Trias i Pujol Badalona SpainPlastic and Reconstructive Surgery Department Hospital Germans Trias i Pujol Badalona SpainOtolaryngology Section, Head and Neck Surgery Hospital Germans Trias i Pujol Badalona SpainPlastic and Reconstructive Surgery Department Hospital Germans Trias i Pujol Badalona SpainOtolaryngology Section, Head and Neck Surgery Hospital Germans Trias i Pujol Badalona SpainPlastic and Reconstructive Surgery Department Hospital Germans Trias i Pujol Badalona SpainOtolaryngology Section, Head and Neck Surgery Hospital Germans Trias i Pujol Badalona SpainPlastic and Reconstructive Surgery Department Hospital Germans Trias i Pujol Badalona SpainAbstract Objective Transoral robotic surgery (TORS) has evolved since its 2009 US Food and Drug Administration approval for use in local stage T1–T2 oropharyngeal carcinoma. The ability to resect increasingly larger and more complex lesions has led to the need to introduce reconstructive techniques through this route, avoiding the classic transmandibular or pull‐through approach. Few studies have compared the safety, efficacy, and advantages of TORS versus classic open approaches in oropharyngeal salvage surgery with reconstruction using microanastomosed flaps. Here we retrospectively compare our center's experience with the open approach and TORS and describe the technical variations used. Methods Between 2013 and 2021, 30 stage III–IV oropharyngeal cancer patients underwent salvage surgery with reconstruction in our center. From 2013 to 2017, 15 patients underwent surgery with the classic open approach, and from 2018 to 2021, an additional 15 patients underwent TORS. We have compared surgical outcomes, post‐surgical results, and survival in the two groups. Results Patient characteristics were similar in the two groups. TORS was associated with shorter surgical time (p < .001), fewer complications (p = .01), shorter hospital stay (p < .001), and lower feeding tube requirements (p = .003). No significant differences were observed between the two groups in the free margin rate or survival. Conclusion Oropharyngeal salvage surgery with TORS with free flap reconstruction reduced associated morbidity compared to the open approach in a patient cohort with poor prognosis. Level of Evidence 4.https://doi.org/10.1002/lio2.1176free flap reconstructionoropharyngeal canceroropharynxrobotic surgery |
| spellingShingle | David Virós Porcuna Constanza Viña Soria Jordi Vila Poyatos Mar Palau Viarnès Paloma Malagon López Carlota Gonzàlez Lluch Carmen Higueras Suñe Carlos M. Pollán Guisasola Cristian Carrasco López Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach Laryngoscope Investigative Otolaryngology free flap reconstruction oropharyngeal cancer oropharynx robotic surgery |
| title | Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach |
| title_full | Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach |
| title_fullStr | Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach |
| title_full_unstemmed | Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach |
| title_short | Oropharyngeal free flap reconstruction: Transoral robotic surgery versus open approach |
| title_sort | oropharyngeal free flap reconstruction transoral robotic surgery versus open approach |
| topic | free flap reconstruction oropharyngeal cancer oropharynx robotic surgery |
| url | https://doi.org/10.1002/lio2.1176 |
| work_keys_str_mv | AT davidvirosporcuna oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT constanzavinasoria oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT jordivilapoyatos oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT marpalauviarnes oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT palomamalagonlopez oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT carlotagonzalezlluch oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT carmenhiguerassune oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT carlosmpollanguisasola oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach AT cristiancarrascolopez oropharyngealfreeflapreconstructiontransoralroboticsurgeryversusopenapproach |