TY - JOUR
T1 - Surgeon experience and complications with transoral robotic surgery (TORS)
AU - Chia, Stanley H.
AU - Gross, Neil D.
AU - Richmon, Jeremy D.
N1 - Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - Objective. To investigate surgeon preferences for perioperative management of transoral robotic surgery (TORS) and explore the frequency of postoperative complications. Study Design. Retrospective survey. Setting. Multi-institutional. Subjects and Methods. An electronic survey was sent to over 300 TORS-trained surgeons in the United States identified by Intuitive Surgical, Inc. Participation was voluntary and solicited by email invitations to participate 3 times over a 1- month period. Results. A total of 2015 procedures were reported by 45 respondent TORS-trained surgeons: 67% academic, 33% nonacademic. A minority of TORS procedures (n = 214, 10.6%) were performed on previously irradiated patients. Neck dissections were performed concurrently (58%) or staged (42%). Fewer than 6% of TORS procedures required tracheotomy or reconstruction. Most surgeons (62%) initiated oral intake on postoperative day 0-1. Of the patients who required readmission, bleeding (n = 62, 3.1%) was the most common cause followed by dehydration (n = 26, 1.3%). Other complications of surgery included tooth injury (n = 29, 1.4%), percutaneous endoscopic gastrostomy (PEG) dependency .6 months (n = 21, 1.0%), temporary hypoglossal nerve injury (n = 18, 0.9%), and lingual nerve injury (n = 11, 0.6%). A total of 6 deaths (0.3%) were reported within 30 days of TORS. All reported deaths were due to postoperative hemorrhage. The complication rate decreased significantly with higher surgeon case volume (.50 cases). Conclusions. TORS is associated with a low major complication rate, early initiation of oral intake, and a low rate of long-term PEG dependency. Postoperative hemorrhage was the most common cause of hospital readmission and postoperative mortality.
AB - Objective. To investigate surgeon preferences for perioperative management of transoral robotic surgery (TORS) and explore the frequency of postoperative complications. Study Design. Retrospective survey. Setting. Multi-institutional. Subjects and Methods. An electronic survey was sent to over 300 TORS-trained surgeons in the United States identified by Intuitive Surgical, Inc. Participation was voluntary and solicited by email invitations to participate 3 times over a 1- month period. Results. A total of 2015 procedures were reported by 45 respondent TORS-trained surgeons: 67% academic, 33% nonacademic. A minority of TORS procedures (n = 214, 10.6%) were performed on previously irradiated patients. Neck dissections were performed concurrently (58%) or staged (42%). Fewer than 6% of TORS procedures required tracheotomy or reconstruction. Most surgeons (62%) initiated oral intake on postoperative day 0-1. Of the patients who required readmission, bleeding (n = 62, 3.1%) was the most common cause followed by dehydration (n = 26, 1.3%). Other complications of surgery included tooth injury (n = 29, 1.4%), percutaneous endoscopic gastrostomy (PEG) dependency .6 months (n = 21, 1.0%), temporary hypoglossal nerve injury (n = 18, 0.9%), and lingual nerve injury (n = 11, 0.6%). A total of 6 deaths (0.3%) were reported within 30 days of TORS. All reported deaths were due to postoperative hemorrhage. The complication rate decreased significantly with higher surgeon case volume (.50 cases). Conclusions. TORS is associated with a low major complication rate, early initiation of oral intake, and a low rate of long-term PEG dependency. Postoperative hemorrhage was the most common cause of hospital readmission and postoperative mortality.
KW - TORS
KW - perioperative management
KW - postoperative complications
KW - transoral robotic surgery
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U2 - 10.1177/0194599813503446
DO - 10.1177/0194599813503446
M3 - Article
C2 - 24013139
AN - SCOPUS:84888357835
SN - 0194-5998
VL - 149
SP - 885
EP - 892
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 6
ER -