TY  - BOOK
AU  - Chia, Stanley H
TI  - Surgeon experience and complications with Transoral Robotic Surgery (TORS)
SN  - 0194-5998
PY  - 2013///
KW  - *Carcinoma/su [Surgery]
KW  - *Clinical Competence/st [Standards]
KW  - *Natural Orifice Endoscopic Surgery
KW  - *Neck Dissection
KW  - *Oropharyngeal Neoplasms/su [Surgery]
KW  - *Robotics
KW  - Carcinoma/co [Complications]
KW  - Dehydration/et [Etiology]
KW  - Humans
KW  - Natural Orifice Endoscopic Surgery/mo [Mortality]
KW  - Natural Orifice Endoscopic Surgery/mt [Methods]
KW  - Operative Time
KW  - Oropharyngeal Neoplasms/co [Complications]
KW  - Patient Readmission
KW  - Postoperative Hemorrhage/et [Etiology]
KW  - Questionnaires
KW  - Retrospective Studies
KW  - Robotics/mt [Methods]
KW  - Survival Analysis
KW  - Treatment Outcome
KW  - United States
KW  - MedStar Washington Hospital Center
KW  - Otolaryngology
KW  - Journal Article
KW  - Multicenter Study
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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
UR  - http://dx.doi.org/10.1177/0194599813503446
ER  -