TY - JOUR
T1 - The effect of transoral robotic surgery on short-term outcomes and cost of care after oropharyngeal cancer surgery
AU - Richmon, Jeremy D.
AU - Quon, Harry
AU - Gourin, Christine G.
PY - 2014/1
Y1 - 2014/1
N2 - Objectives/Hypothesis Transoral surgery is an increasingly frequent treatment modality for tumors of the upper aerodigestive tract. This is in large part related to the introduction of transoral robotic surgery (TORS) for oropharyngeal cancer resection, which has demonstrated excellent oncologic and functional outcomes. There is limited data, however, on how TORS compares to traditional open surgery in overall costs and length of hospitalization. With increasing pressure to contain and reduce the costs of medical care, we sought to evaluate the impact of TORS on a national sample of patients undergoing surgery for oropharyngeal cancer. Study Design Retrospective cross-sectional study. Methods A cross-sectional analysis of 9,601 patients who underwent an extirpative procedure for a malignant oropharyngeal neoplasm in 2008 to 2009 was performed using discharge data from the Nationwide Inpatient Sample. Results TORS was performed in 116 (1.2%) of cases. TORS patients had a lower rate of gastrostomy tube placement (0% vs. 19%), tracheotomy tube placement (0% vs. 36%), and nonroutine discharge (0% vs. 44%) compared to patients undergoing non-TORS procedures. After controlling for all other variables, including comorbidity, extent of surgery, and teaching hospital status, TORS was associated with significantly decreased length of hospitalization (mean, -1.5 days) and hospital-related costs (mean, -4,285). Conclusions TORS is becoming an increasingly frequent technique to treat tumors of the upper aerodigestive tract. These data demonstrate that TORS is associated with a decreased length of hospitalization and hospital-related costs compared to other surgical techniques. Level of Evidence 2c. Laryngoscope, 124:165-171, 2014
AB - Objectives/Hypothesis Transoral surgery is an increasingly frequent treatment modality for tumors of the upper aerodigestive tract. This is in large part related to the introduction of transoral robotic surgery (TORS) for oropharyngeal cancer resection, which has demonstrated excellent oncologic and functional outcomes. There is limited data, however, on how TORS compares to traditional open surgery in overall costs and length of hospitalization. With increasing pressure to contain and reduce the costs of medical care, we sought to evaluate the impact of TORS on a national sample of patients undergoing surgery for oropharyngeal cancer. Study Design Retrospective cross-sectional study. Methods A cross-sectional analysis of 9,601 patients who underwent an extirpative procedure for a malignant oropharyngeal neoplasm in 2008 to 2009 was performed using discharge data from the Nationwide Inpatient Sample. Results TORS was performed in 116 (1.2%) of cases. TORS patients had a lower rate of gastrostomy tube placement (0% vs. 19%), tracheotomy tube placement (0% vs. 36%), and nonroutine discharge (0% vs. 44%) compared to patients undergoing non-TORS procedures. After controlling for all other variables, including comorbidity, extent of surgery, and teaching hospital status, TORS was associated with significantly decreased length of hospitalization (mean, -1.5 days) and hospital-related costs (mean, -4,285). Conclusions TORS is becoming an increasingly frequent technique to treat tumors of the upper aerodigestive tract. These data demonstrate that TORS is associated with a decreased length of hospitalization and hospital-related costs compared to other surgical techniques. Level of Evidence 2c. Laryngoscope, 124:165-171, 2014
KW - Nationwide Inpatient Sample
KW - TORS
KW - Transoral robotic surgery
KW - complications
KW - head and neck neoplasms
KW - surgery
UR - http://www.scopus.com/inward/record.url?scp=84895838130&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84895838130&partnerID=8YFLogxK
U2 - 10.1002/lary.24358
DO - 10.1002/lary.24358
M3 - Article
C2 - 23945993
AN - SCOPUS:84895838130
SN - 0023-852X
VL - 124
SP - 165
EP - 171
JO - Laryngoscope
JF - Laryngoscope
IS - 1
ER -