Morbidity and Mortality Following Transoral Robotic Surgery, a Prospective Single Centre Study.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Robotic Surgery

Background:

• Transoral robotic surgery (TORS) is increasingly used for benign and malignant head and neck pathologies.
• Assessing the complication profile and mortality associated with TORS is crucial for patient safety and procedural refinement.

Purpose of the Study:

• To comprehensively review complications and mortality following transoral robotic surgery (TORS) for both benign and malignant conditions.
• To identify risk factors and patterns associated with TORS-related adverse events.

Main Methods:

• Prospective observational study design.
• Systematic review of complications including hemorrhage, airway issues, swallowing difficulties, fistulas, and mortality.
• Analysis of complication rates in relation to tumor stage and surgical experience.

Main Results:

• Postoperative hemorrhage (8.7%) was the most frequent complication, with 2 (1.7%) mortalities observed.
• Other complications included airway issues (1.7%), aspiration pneumonia (1.7%), swallowing problems requiring nasogastric feeding (7%), and transient nasal regurgitation (3.5%).
• Higher T-stage oropharyngeal squamous cell carcinoma (OPSCC) correlated with increased resection size, morbidity, and a higher risk of postoperative hemorrhage and mortality.

Conclusions:

• TORS is associated with a range of complications, with postoperative hemorrhage being the most common.
• The initial phase of TORS implementation demonstrated a learning curve effect on complication rates.
• Advanced T-stage oropharyngeal cancers present a higher risk for significant morbidity and mortality following TORS due to the need for larger resections.