{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:38:59Z","timestamp":1747183139950,"version":"3.40.5"},"reference-count":27,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T00:00:00Z","timestamp":1618185600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Trans\u2010oral robotic surgery (TORS) facilitates surgical resection of tumours as an alternative to open surgery and has demonstrated favourable oncological results. Given the novelty of TORS and the paucity of evidence on TORS\u2010specific complications in a rural setting, we report our experience with TORS at an Australian rural head and neck centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of all robotic cases performed at a regional head and neck centre in Queensland was undertaken from 2014 to 2019. Patient demographics, pre\u2010operative surgical risk, complications and outcomes such as margins and cancer recurrence were recorded. Complications were graded based on the Clavien\u2010Dindo grading system. Descriptive statistics were used to present patient characteristics and statistical analyses were performed using Stata.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two TORS surgeries were performed. Twenty\u2010one had histology confirming malignancy. There were no adverse intraoperative effects. Overall, seven patients (16.7%) had at least one complication. Four were recorded as a Clavien\u2010Dindo 3b (post\u2010operative bleed, wound infection and drain dislodgment). Of two cases with residual positive margins, one declined further surgery, and another received chemoradiotherapy. One patient recurred with distant metastatic disease, and another had locoregional nodal recurrence. The distribution of complications was significant across the pre\u2010operative risk categories for both American Society of Anaesthesiologists and surgical risk score (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>TORS in a rural head and neck centre is a safe and viable treatment option for patients so long as this is undertaken with appropriate training, mentorship and teamwork.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16731","type":"journal-article","created":{"date-parts":[[2021,4,12]],"date-time":"2021-04-12T13:55:39Z","timestamp":1618235739000},"page":"2345-2351","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Trans\u2010oral robotic surgery: a safe and effective tool in head and neck surgery in an Australian rural setting"],"prefix":"10.1111","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6159-7240","authenticated-orcid":false,"given":"Johnson","family":"Huang","sequence":"first","affiliation":[{"name":"Ear, Nose and Throat Department Toowoomba Hospital  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Phillips","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Department Toowoomba Hospital  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9923-2087","authenticated-orcid":false,"given":"James","family":"Nightingale","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Department Toowoomba Hospital  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srinivas","family":"Kondalsamy\u2010Chennakesavan","sequence":"additional","affiliation":[{"name":"Rural Clinical School The University of Queensland  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger","family":"Grigg","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Department Toowoomba Hospital  Toowoomba Queensland Australia"},{"name":"Ear, Nose and Throat Department St Andrew's Toowoomba Hospital  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suresh","family":"Mahendran","sequence":"additional","affiliation":[{"name":"Ear, Nose and Throat Department Toowoomba Hospital  Toowoomba Queensland Australia"},{"name":"Ear, Nose and Throat Department St Andrew's Toowoomba Hospital  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,12]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2017.02.022"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24059"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.04.005"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21144"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-016-4966-y"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30410-3"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2016.09.008"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000580"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2014.0265"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14099"},{"key":"e_1_2_8_12_1","unstructured":"Australian Institute of Health and Welfare.Rural & Remote Australians. 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