Early adoption of transoral robotic surgical program: preliminary outcomes.

Authors

David Cognetti, Thomas Jefferson UniversityFollow
Adam Luginbuhl, Thomas Jefferson UniversityFollow
Anthony L. Nguyen, Thomas Jefferson UniversityFollow
Joseph Curry, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

9-1-2012

Comments

This article has been peer reviewed. It is the authors' final version prior to publication in Otolaryngology-head and neck surgery

2012 Sep; Volume 147, Issue 3, pp. 482-8.

The published version is available at DOI: 10.1177/0194599812443353. Copyright © Sage

Abstract

OBJECTIVE: The objective of this study is to demonstrate the feasibility and safety of establishing a transoral robotic surgical (TORS) program in the post-Food and Drug Administration (FDA) approval setting. Early outcomes are compared with the previously reported results of pioneering centers.

STUDY DESIGN: Clinical data from a prospective TORS study.

SETTING: Academic university institution.

SUBJECTS AND METHODS: Sixty-one patients treated with 63 TORS procedures. Main outcome measures: intraoperative times, margin status, complications, time to diet, and percutaneous endoscopic gastrostomy (PEG) tube retention rate. The authors also report oncologic outcomes on their first 30 patients.

RESULTS: The spectrum of subsites included tongue base, tonsil, parapharyngeal space, retromolar trigone, supraglottis, and posterior pharyngeal wall. Surgical console time averaged 79 ± 53 minutes. After re-resection of 4 patients, final negative margin status was 94% (50/53). A subset of 30 patients with squamous cell carcinoma reaching an average of 18 months of follow-up had a local regional control rate of 97% with a disease-free survival rate of 90%. The PEG tube retention rate was 7%. Complications included 2 readmissions with dehydration, 1 aspiration pneumonia, and 2 with minor oropharyngeal bleeding. Ninety-one percent of patients resumed an oral diet by the first postoperative visit.

CONCLUSION: The initiation of a TORS program in the post-FDA setting can be achieved in a safe and efficient manner. Early results of pioneering TORS centers are reproducible. Continued investigation of TORS as a treatment option for oropharyngeal carcinoma is warranted.

Recommended Citation

Cognetti, David; Luginbuhl, Adam; Nguyen, Anthony L.; and Curry, Joseph, "Early adoption of transoral robotic surgical program: preliminary outcomes." (2012). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 24.
https://jdc.jefferson.edu/otofp/24

PubMed ID

22496060