{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T22:44:57Z","timestamp":1785451497070,"version":"3.56.0"},"reference-count":35,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T00:00:00Z","timestamp":1622937600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>We reviewed the indications, peroperative feasibility, and postoperative clinical outcomes of our first 50 consecutive patients who underwent free flap reconstruction after TORS for complex pharyngeal defects at our institution. We analyzed indications according to previous radiotherapy, the size of the resection, and the transoral exposure of critical structures. We reviewed surgical data, postoperative complications, and functional outcomes comprising tracheostomy and alimentation management. Indications were upfront surgery (34%), a second primary surgery after radiotherapy (28%), or salvage surgery after chemoradiotherapy failure (38%). Localizations were the tongue base (44%), tonsillar fossa (28%), pharyngeal wall (22%), and soft palate (6%). T-classifications were T1 (6%), T2 (52%), T3 (20%), and T4 (22%). The mean length of the surgery was 574 min. Two patients were intraoperatively converted to a conventional approach at the beginning of the learning curve. In conclusion, TORS and free flap reconstruction in complex situations were associated with low rates of postoperative complications and satisfactory functional outcomes. They were, however, associated with a renewed learning curve.<\/jats:p>","DOI":"10.3390\/cancers13112831","type":"journal-article","created":{"date-parts":[[2021,6,6]],"date-time":"2021-06-06T23:59:55Z","timestamp":1623023995000},"page":"2831","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Indications and Clinical Outcomes of Transoral Robotic Surgery and Free Flap Reconstruction"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7604-4964","authenticated-orcid":false,"given":"Philippe","family":"Gorphe","sequence":"first","affiliation":[{"name":"Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Temam","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Moya-Plana","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Leymarie","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Kolb","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, UC San Diego, University of California, La Jolla, CA 92121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Apolline","family":"Bout-Roumazeilles","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quentin","family":"Qassemyar","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Tenon Hospital, AP-HP, 75020 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Benmoussa","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fran\u00e7ois","family":"Honart","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Gustave Roussy Institute, University Paris-Saclay, 94800 Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1523","DOI":"10.1002\/cncr.29938","article-title":"Increase in primary surgical treatment of T1 and T2 oropharyngeal squamous cell carcinoma and rates of adverse pathologic features: National Cancer Data Base","volume":"122","author":"Cracchiolo","year":"2016","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.surge.2016.09.004","article-title":"Role of transoral robotic surgery in current head & neck practice","volume":"15","author":"Hamilton","year":"2017","journal-title":"Surgeon"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Chillakuru, Y., Benito, D.A., Strum, D., Mehta, V., Saini, P., Shim, T., Darwish, C., Joshi, A.S., Thakkar, P., and Goodman, J.F. 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