Meccariello Giuseppe, Montevecchi Filippo, Sgarzani Rossella, De Vito Andrea, D'Agostino Giovanni, Gobbi Riccardo, Bellini Chiara, Vicini Claudio
Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Azienda USL della Romagna, Forlì, Italy.
Oral Oncol. 2017 Mar;66:108-111. doi: 10.1016/j.oraloncology.2017.01.003. Epub 2017 Jan 11.
Transoral robotic surgery (TORS) is a fascinating new technique that has been proved to be a safe and feasible for selected oropharyngeal cancers. Furthermore, TORS offers several advantages in the treatment of locoregionally advanced cancers. Nevertheless, the careful selection of patients is the keypoint for a successful application of this therapeutic modality. However, the reconstruction of large oropharyngeal defects is challenging due to the restoration of velopharyngeal competency and swallowing. Moreover, the absence of mandibular splitting increases the difficulties faced by reconstructive surgeons. The paradigm for oropharyngeal reconstruction has undergone changes reflecting the overall change in the trend of the treatment alternatives over the last few decades. The flap choice and harvesting should be tailored in order to obtain significant advantages both in terms of function and should be easy to inset. In this review, we analysed the strengths and weaknesses of the various flaps used in the TORS framework.
经口机器人手术（TORS）是一项引人入胜的新技术，已被证明对特定的口咽癌是安全可行的。此外，TORS在治疗局部晚期癌症方面具有多个优势。然而，仔细选择患者是成功应用这种治疗方式的关键。然而，由于腭咽功能和吞咽功能的恢复，大型口咽缺损的重建具有挑战性。此外，不进行下颌骨劈开增加了重建外科医生面临的困难。口咽重建的模式已经发生了变化，反映了过去几十年治疗选择趋势的总体变化。皮瓣的选择和切取应进行调整，以便在功能方面获得显著优势，并且易于植入。在本综述中，我们分析了TORS框架中使用的各种皮瓣的优缺点。
