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Transoral robotic-assisted free flap reconstruction after radiation therapy in hypopharyngeal carcinoma: report of two cases

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Abstract

The objective was to assess the feasibility and safety of transoral robotic surgery (TORS)-assisted free flap reconstruction for hypopharyngeal carcinoma after radiation therapy. The study evaluated the feasibility, surgical margins, the need for a tracheotomy, a nasogastric tube as well as surgery-related complications. Two patients underwent TORS-assisted free flap reconstruction after radiation therapy. The resection margins were free of tumor in both patients. A tracheotomy was performed in one patient who had been decannulated on the sixth postoperative day. One patient resumed satisfactory oral feeding in the fourth postoperative month and the second patient on postoperative day 7. No intraoperative complication and one postoperative complication (neck hematoma) were reported. After a follow-up period of 24 and 30 months, no local recurrence was observed. TORS is feasible for hypopharyngeal resection and assisted free flap reconstruction after radiation therapy. It represents a further step in the development of minimally invasive surgery for the treatment of head and neck cancers with laryngeal preservation.

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References

  1. Clark JR, de Almeida J, Gilbert R, Irish J, Brown D, Neligan P, Gullane PJ (2006) Primary and salvage (hypo)pharyngectomy: analysis and outcome. Head Neck 28:671–677

    Article  PubMed  Google Scholar 

  2. Relic A, Scheich M, Stapf J, Voelter C, Hoppe F, Hagen R, Pfreundner L (2009) Salvage surgery after induction chemotherapy with paclitaxel/cisplatin and primary radiotherapy for advanced laryngeal and hypopharyngeal carcinomas. Eur Arch Otorhinolaryngol 266:1799–1805

    Article  PubMed  CAS  Google Scholar 

  3. Tsou YA, Hua CH, Lin MH, Tseng HC, Tsai MH, Shaha A (2010) Comparison of pharyngocutaneous fistula between patients followed by primary laryngopharyngectomy and salvage laryngopharyngectomy for advanced hypopharyngeal cancer. Head Neck 32:1494–1500

    Article  PubMed  Google Scholar 

  4. Weinstein GS, O’Malley BW Jr, Snyder W, Sherman E, Quon H (2007) Transoral robotic surgery: radical tonsillectomy. Arch Otolaryngol Head Neck Surg 113:1220–1226

    Article  Google Scholar 

  5. Genden EM, Desai S, Sung CK (2009) Transoral robotic surgery for the management of head and neck cancer: a preliminary experience. Head Neck 31:283–289

    Article  PubMed  Google Scholar 

  6. Iseli TA, Kulbersh BD, Ideli CE, Carroll WR, Rosenthal EL, Magnuson JS (2009) Functional outcomes after transoral robotic surgery for head and neck cancer. Otolaryngol Head Neck Surg 141:166–171

    Article  PubMed  Google Scholar 

  7. Park YM, Kim WS, Byeon HK, De Virgilio A, Jung JS, Kim SH (2010) Feasibility of transoral robotic hypopharyngectomy for early-stage hypopharyngeal carcinoma. Oral Oncol 46:597–602

    Article  PubMed  Google Scholar 

  8. Moore EJ, Olsen SM, Laborde RR et al (2012) Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc 87:219–225

    Article  PubMed  Google Scholar 

  9. Lawson G, Matar N, Remacle M, Jamart J, Bachy V (2011) Transoral robotic surgery for the management of head and neck tumors: learning curve. Eur Arch Otorhinolaryngol 268:1795–1801

    Article  PubMed  Google Scholar 

  10. Hans S, Badoual C, Gorphe P, Brasnu D (2012) Transoral robotic surgery for head and neck carcinomas. Eur Arch Otorhinolaryngol 269:1979–1984

    Article  PubMed  Google Scholar 

  11. Mukhija VK, Sung C, Desai SC, Wanna G, Genden EM (2009) Transoral robotic assisted free flap reconstruction. Otolaryngol Head Neck Surg 140:124–125

    Article  PubMed  Google Scholar 

  12. Selber JC, Robb G, Serletti JM, Weinstein G, Weber R, Holsinger FC (2010) Transoral robotic free flap reconstruction of oropharyngeal defects: a preclinical investigation. Plast Reconstr Surg 125:896–900

    Article  PubMed  CAS  Google Scholar 

  13. Selber JC (2010) Transoral robotic reconstruction of oropharyngeal defects: a case series. Plast Reconstr Surg 125:1978–1987

    Google Scholar 

  14. Garfein ES, Greaney PJ Jr, Easterlin B, Schiff B, Smith RV (2011) Transoral robotic reconstructive surgery reconstruction of a tongue base defect with a radial forearm flap. Plastic Reconstruct Surg 127:2352–2354

    Article  CAS  Google Scholar 

  15. Ghanem TA (2011) Transoral robotic-assisted microvascular reconstruction of the oropharynx. Laryngoscope 121:580–582

    Article  PubMed  Google Scholar 

  16. Genden EM, Park R, Smith C, Kotz T (2011) The role of reconstruction for transoral robotic pharyngectomy and concomitant neck dissection. Arch Otolaryngol Head Neck Surg 137:151–156

    Article  PubMed  Google Scholar 

  17. Longfield EA, Holsinger FC, Selber JC (2012) Reconstruction after robotic head and neck Surgery: when and Why. J Reconstr Microsurg 28:445–450

    Article  PubMed  Google Scholar 

  18. Sobin LH, Gospodarowicz M, Wittekind C (2009) UICC international union against cancer. TNM classification of malignant tumors. 7th edn. Wiley, New York, pp 31–35

  19. Byers RM (1994) Anatomic correlates in head and neck surgery. The lateral pharyngotomy Head Neck 16:460–462

    Article  CAS  Google Scholar 

  20. Ogura JH, Marks JE, Freeman RB (1980) Results of conservation surgery for cancers of the supraglottis and pyriform sinus. Laryngoscope 90:591–600

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Richard Medeiros, Medical Editor of Medical Editing International for editing the final manuscript.

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Authors and Affiliations

  1. Department of Otolaryngology, Head Neck Surgery, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, 20 Rue Leblanc, 75015, Paris, France

    Stéphane Hans, Caroline Hoffman & Daniel Brasnu

  2. Faculté de médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

    Stéphane Hans, Caroline Hoffman, Cécile Badoual & Daniel Brasnu

  3. Department of Otolaryngology, Head Neck Surgery, Institut Curie, 26 rue d’Ulm, 75005, Paris, France

    Thomas Jouffroy, Angélique Girod & Jose Rodriguez

  4. Suite 6, Level 6, 66 Pacific Highway, St Leonards, Sydney, NSW, 2065, Australia

    David Veivers

  5. Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France

    Cécile Badoual

Authors
  1. Stéphane Hans
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  2. Thomas Jouffroy
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  3. David Veivers
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  4. Caroline Hoffman
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  5. Angélique Girod
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  6. Cécile Badoual
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  7. Jose Rodriguez
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  8. Daniel Brasnu
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Correspondence to Stéphane Hans.

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Hans, S., Jouffroy, T., Veivers, D. et al. Transoral robotic-assisted free flap reconstruction after radiation therapy in hypopharyngeal carcinoma: report of two cases. Eur Arch Otorhinolaryngol 270, 2359–2364 (2013). https://doi.org/10.1007/s00405-013-2566-1

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  • DOI: https://doi.org/10.1007/s00405-013-2566-1

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