Surgeon experience and complications with Transoral Robotic Surgery (TORS).

MedStar author(s):
Citation: Otolaryngology - Head & Neck Surgery. 149(6):885-92, 2013 Dec.PMID: 24013139Institution: MedStar Washington Hospital CenterDepartment: OtolaryngologyForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter StudySubject headings: *Carcinoma/su [Surgery] | *Clinical Competence/st [Standards] | *Natural Orifice Endoscopic Surgery | *Neck Dissection | *Oropharyngeal Neoplasms/su [Surgery] | *Robotics | Carcinoma/co [Complications] | Dehydration/et [Etiology] | Humans | Natural Orifice Endoscopic Surgery/mo [Mortality] | Natural Orifice Endoscopic Surgery/mt [Methods] | Operative Time | Oropharyngeal Neoplasms/co [Complications] | Patient Readmission | Postoperative Hemorrhage/et [Etiology] | Questionnaires | Retrospective Studies | Robotics/mt [Methods] | Survival Analysis | Treatment Outcome | United StatesYear: 2013Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0194-5998
Name of journal: Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck SurgeryAbstract: 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.OBJECTIVE: To investigate surgeon preferences for perioperative management of transoral robotic surgery (TORS) and explore the frequency of postoperative complications.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).SETTING: Multi-institutional.STUDY DESIGN: Retrospective survey.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.All authors: Chia SH, Gross ND, Richmon JDFiscal year: FY2014Digital Object Identifier: Date added to catalog: 2014-02-24
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 24013139 Available 24013139

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

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.

OBJECTIVE: To investigate surgeon preferences for perioperative management of transoral robotic surgery (TORS) and explore the frequency of postoperative complications.

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).

SETTING: Multi-institutional.

STUDY DESIGN: Retrospective survey.

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.

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