title: Salvage Transoral Robotic Surgery for Recurrent or Residual Head and Neck Squamous Cell Carcinoma: A Single Institution Experience.
abstract: BACKGROUND
  The present study was conducted to evaluate the technical feasibility, safety and adequacy of surgical margins with salvage transoral robotic surgery (TORS) for recurrent or residual head and neck squamous cell carcinoma patients.
  
  
  METHODS
  Thirty patients who underwent salvage TORS using the 'DaVinci' robot were enrolled in the study and data related to their surgical time, complications and functional outcome were recorded.
  
  
  RESULTS
  The feasibility of salvage TORS in our study was observed to be 100%. Positive margins were encountered in only 6.7% of patients. Mean blood loss was 23.3 ml with no patient requiring blood transfusion. Postoperative complications in the form of primary haemorrhage requiring active surgical intervention occurred in 13.3%. Oral feeding could be started as early as the 3rd postoperative day in a few patients, with nasogastric tubes being removed on the 12th postoperative day. Long term gastrostomy tube dependency was seen in 10% cases. Median survival of patients was 19 months.
  
  
  CONCLUSIONS
  Salvage TORS is a safe, effective and feasible option in the management of treatment failure cases. It offers an alternative surgical approach with unexpected benefits in terms of tracheostomy tube use, Ryle's tube and gastrostomy dependence.
authors.affiliation: Department of Surgical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India E-mail : abhinavdewan25@gmail.com.
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: Himanshu
authors.initials: H
authors.lastname: Shukla
authors.forename: Rupal
authors.initials: R
authors.lastname: Sinha
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D018365:Neoplasm, Residual / Q000601:surgery; D061646:Operative Time; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D065287:Robotic Surgical Procedures / Q000379:methods*; D016879:Salvage Therapy / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome