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Hemorrhage after transoral robotic-assisted surgery
Scott A Asher1, Hilliary N White, Alexandra E Kejner
1Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, School of Medicine at University of Alabama at Birmingham, Birmingham, Alabama 35233, USA.
Summary
Postoperative bleeding occurred in 7.5% of transoral robotic-assisted surgery patients, with higher rates in those taking antithrombotic medications. Surgeons should recognize this risk for improved hemorrhage control.
Area of Science:
- Otolaryngology
- Robotic Surgery
- Surgical Complications
Background:
- Transoral robotic-assisted surgery (TORS) is increasingly adopted by head and neck surgeons.
- Postoperative bleeding is a significant complication following TORS.
Purpose of the Study:
- To examine postoperative bleeding complications in TORS patients.
- To identify risk factors for hemorrhage.
- To discuss hemorrhage control strategies.
Main Methods:
- A case series design with retrospective chart review.
- Analysis of 147 consecutive TORS patients at a tertiary academic medical center (March 2007 - September 2011).
Main Results:
- Postoperative hemorrhage occurred in 11 of 147 (7.5%) patients, with 9 requiring reoperation.
- Patients on antithrombotic medication had a significantly higher bleeding rate (17%) compared to those not on these medications (3%), P = .0057.
- Bleeding rates in salvage surgery (10.3%) were not significantly different from primary surgery (6.8%).
Conclusions:
- Antithrombotic medication use is a significant risk factor for postoperative bleeding after TORS.
- Recognition of this risk is crucial for effective hemorrhage management.
- Non-robotic techniques are effective for managing TORS-related bleeding.
