Kumar S, Mettias B, Laugharne D, Mortimore S
Department of Otolaryngology & Head and Neck Surgery, University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Uttoxeter New Road, Derby, DE22 3NE UK.
Department of Maxillofacial & Head and Neck Surgery, University Hospitals of Derby and Burton NHS Trust, Royal Derby Hospital, Uttoxeter New Road, Derby, DE22 3NE UK.
Indian J Otolaryngol Head Neck Surg. 2022 Sep;74(3):422-426. doi: 10.1007/s12070-021-03033-6. Epub 2022 Jan 18.
To review complications including mortality after transoral robotic surgery (TORS) for both benign and malignant pathologies. This is a prospective observational study. Postoperative haemorrhage (8.7%) was the most common complication and 2 (1.7%) mortality were seen in this study. Airway complications and tracheostomy (1.7%), aspiration pneumonia (1.7%), swallowing problems and nasogastric feeding (7%), intra-operative pharyngocutaneous fistula (0.9%) and transient nasal regurgitation (3.5%) were also seen. The more tissue is removed the more is the risk of complication. Complications were mainly seen in the first year of starting the service of TORS and it is a reflection of the learning curve. However, secondary haemorrhage did not follow any pattern in our series. The postoperative haemorrhage was more common in patients with T2 oropharyngeal carcinoma. The mortality was seen in 2 patients (1.7%) with T2 oropharyngeal carcinoma due to postoperative haemorrhage. Higher T stage of oropharyngeal squamous cell carcinoma (OPSCC) needs bigger resection with resultant increase in morbidity.
回顾经口机器人手术(TORS)治疗良性和恶性病变后的并发症,包括死亡率。这是一项前瞻性观察研究。术后出血(8.7%)是最常见的并发症,本研究中有2例(1.7%)死亡。还观察到气道并发症和气管切开术(1.7%)、吸入性肺炎(1.7%)、吞咽问题和鼻饲(7%)、术中咽皮瘘(0.9%)以及短暂性鼻反流(3.5%)。切除的组织越多,并发症风险越高。并发症主要出现在开展TORS服务的第一年,这反映了学习曲线。然而,在我们的系列病例中,继发性出血没有任何规律。术后出血在T2期口咽癌患者中更为常见。2例T2期口咽癌患者(1.7%)因术后出血死亡。口咽鳞状细胞癌(OPSCC)的T分期越高,需要的切除范围越大,导致发病率增加。