title: Functional Outcomes and Complications of Robot-Assisted Free Flap Oropharyngeal Reconstruction.
abstract: BACKGROUND
  Robotic surgical systems provide a clear, magnified 3-dimensional visualization as well as precise, stable instrumental movement, thereby minimizing technical difficulties that may be encountered in the surgical treatment of oropharyngeal tumors. This study assessed the outcomes of robotic-assisted free flap oropharyngeal reconstruction compared with those of conventional free flap reconstruction.
  
  
  METHODS
  A retrospective review of 47 patients who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects was conducted over a 20-month period (May 2013-December 2014). Complications were evaluated for a robot-assisted reconstruction group and a conventional reconstruction group; postoperative complication rates and revision rates were further evaluated. The Functional Intraoral Glasgow Scale (FIGS) was adopted for functional outcome assessment.
  
  
  RESULTS
  This study recruited 47 people who underwent reconstructive operations using a free radial forearm fasciocutaneous flap for oropharyngeal defects (14 robot-assisted and 33 conventional reconstructions). The mean postoperative FIGS score was 10.29 ± 2.02 in the robot-assisted group (P = 0.010) and 8.42 ± 2.29 in the conventional group at 1 month postoperatively. The mean postoperative FIGS score was 12.57 ± 1.91 in the robot-assisted group (P = 0.005) and 9.91 ± 3.09 in the conventional group at 3 months postoperatively. Complication rates between the robot-assisted and conventional groups were similar for flap failure (P = 0.531), partial necrosis, wound infection, hematoma or seroma formation (P = 0.893), wound dehiscence, and fistula formation (P = 0.515). The number of flap revision operations requiring additional surgery (P = 0.627) was comparable between the cohorts.
  
  
  CONCLUSIONS
  There is no significant difference in complications or revision rates between the robot-assisted and conventional oropharyngeal reconstructions. The functional postoperative outcomes of robot-assisted reconstructions are superior to those of conventional reconstructions. Robotic surgical systems provide a safe option with optimal postoperative oral function for the free flap reconstruction of oropharyngeal defects without lip or mandible splitting.
authors.affiliation: From the *Division of Plastic and Reconstructive Surgery, Department of Surgery, †Department of Otolaryngology, Taichung Veterans General Hospital, Taichung; and ‡Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China.
authors.forename: Yueh-Chi
authors.initials: YC
authors.lastname: Tsai
authors.forename: Shih-An
authors.initials: SA
authors.lastname: Liu
authors.forename: Chih-Sheng
authors.initials: CS
authors.lastname: Lai
authors.forename: Yen-Wei
authors.initials: YW
authors.lastname: Chen
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Lu
authors.forename: Jung-Hsing
authors.initials: JH
authors.lastname: Yen
authors.forename: I-Chen
authors.initials: IC
authors.lastname: Chen
mesh_terms: D005260:Female; D005542:Forearm; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome