الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Tran’s oral robotic surgery (TORS) is defined as surgery done via the oral cavity that uses a minimum of three arms and allows bimanual surgical techniques, which allow resection of oropharyngeal tumors with benefits of limiting tissue dissection, disruption of speech and swallowing musculature, avoiding major neurovascular structures, and limiting injury to normal tissue.
The present study aimed to evaluate functional and oncological outcome of primary and recurrent oropharyngeal cancer using Tran’s oral robotic surgery (TORS). Thirty six (36) patients were enrolled in this study at the Division of Head and Neck Surgery, European Institute of Oncology, Milan, Italy.
group An included the first 24 consecutive salvage TORS patients between October 2007 to August 2012. group B included 12 Primary TORS patients between April 2008 to November 2012.
Salvage TORS was performed on 24 patients (group A), most of whom were men [ 16 (67%)] with a mean ± SD55.54 ± 10.45 years ranged from 32–71 years while in 12 patient (group B) primary TORS, most of them were men [10(83%)] with a mean± SD 58.0 ± 10.67 years ranged from 43–77 yearsز
Assessment of intra- and post-operative Outcome were included , The overall mean±SD operative time to perform the TORS procedure in salvage and primary groups were 106.08±0.837 minutes and 107.4±0.952 minutes respectively included the mean± SD of robotic setup time 25±13 and 19.7±7.4 minutes for exposure and robotic positioning in salvage and primary a groups respectively, Surgical setup time decreased dramatically as the operating room staff and physicians gained experience with the daVinci Surgical System , nasotracheal intubation was extubated immediately after the operation in 16(72.2%) patients in salvage TORS group and 5(42%) patients in a primary TORS group . 15 (62%) and 7 (58.5%) of salvage and primary Patients group required a tracheostomy for protection from suspected airway edema and they were decannulated at a mean ±SD 12.93 ± 12.2 days and 6.71± 1.6 respectively. prior to discharge there was no patients from both groups remained tracheotomy tube dependent. Negative margins were achieved in 31\36 in both primary and salvage TORS groups together. There was no statistical significant difference (p= 0.476) in the length of hospital stay for salvage TORS group with a mean ±SD 6.17±2.35 days compared with primary TORS group with a mean ±SD 5.58±2.15 days and There was no significant difference (p= 0.432) in postoperative diet between robotic primary and robotic salvage groups. No complication (hematoma–infection) was reported in postoperative salvage or primary groups.
The data show promising initial results following TORS in primary and salvage group, the overall survival rate of primary group was 100% while in salvage group the overall survival rate was 71%.
TORS is particularly well-suited for early-stage oropharyngeal squamous cell cancer Outcomes are better than traditional, open surgical approaches and compare favorably to those achieve with definitive RT and CRT
When feasible, robotic-assisted surgery is an acceptable procedure for resection of both primary and recurrent oropharyngeal tumors.