title: Transoral robotic surgery in management of oropharyngeal cancers: a preliminary experience at a tertiary cancer centre in India.
abstract: BACKGROUND
  The aim of this observational prospective study was to determine the technical feasibility, safety and adequacy of surgical margins for transoral robotic surgery (TORS) in oropharyngeal cancers.
  
  
  METHODS
  From March 2013 to May 2014, 60 patients with oropharyngeal lesions underwent TORS with or without neck dissection using the 'DaVinci' robot. Patients were observed and data recorded on surgical time, blood loss, complications and functional outcome of patients.
  
  
  RESULTS
  All 60 patients underwent TORS, with neck dissection performed in 45 of the patients. A positive margin was seen in two patients (3.3 %). Intent to treatment was radical in 42 patients and salvage in 18 patients. None of the patients required tracheostomy, and one patient (1.66 %) died postoperatively. Postoperative complications in the form of primary haemorrhage required active intervention in three patients. Average estimated blood loss was 26.5 ± 31.1 ml. Postoperatively, all patients had adequate swallowing and speech function with nasal twang reported in three patients on long-term follow up. Patients started tolerating oral feeds within a week of procedure (mean 3.96 days), with the nasogastric tube removed on the ninth postoperative day (mean 9.19 days). No long-term gastrostomy tube dependency was reported.
  
  
  CONCLUSIONS
  TORS is a safe, feasible, minimally invasive procedure in patients with oropharyngeal cancers. It has the least morbidity and offers benefits in terms of avoidance of tracheostomy tube, prolonged Ryle's tube and gastrostomy dependency.
authors.affiliation: Department of Surgical Oncology, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India.
authors.forename: Surender
authors.initials: S
authors.lastname: Dabas
authors.forename: Abhinav
authors.initials: A
authors.lastname: Dewan
authors.forename: Reetesh
authors.initials: R
authors.lastname: Ranjan
authors.forename: Ajay Kumar
authors.initials: AK
authors.lastname: Dewan
authors.forename: Anoop
authors.initials: A
authors.lastname: Puri
authors.forename: Swati H
authors.initials: SH
authors.lastname: Shah
authors.forename: Rupal
authors.initials: R
authors.lastname: Sinha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002173:Cancer Care Facilities; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D062606:Tertiary Care Centers