Complications following transoral robotic surgery (TORS): A detailed institutional review of complications

Publication date: April 2017
Source:Oral Oncology, Volume 67
Author(s): Ashley Hay, Jocelyn Migliacci, Daniella Karassawa Zanoni, Jay O. Boyle, Bhuvanesh Singh, Richard J. Wong, Snehal G. Patel, Ian Ganly
ObjectivesTo report the complications occurring following TORS and to identify the factors predictive of complications.MethodsFollowing IRB approval a retrospective analysis of all TORS operations at our institution was performed. Postoperative complications within 45days were collected and graded with the Clavien-Dindo system. Complications were categorized into groups: all complications, not related to TORS and TORS related. Unadjusted odds ratios were calculated to test association between patients with and without a complication.Results122 TORS operations were carried out between June 2010 and August 2015. 77% were male, with a median age of 57. There were 92 primary tumor resections, 10second head and neck primary resections, 13 salvage procedures and 7 other indications. Surgical resection involved 1, 2 or >3 sub-sites in 36%, 28% and 36% patients, respectively.Overall, there were 107 complications (66 TORS related, 41 non-TORS related) that occurred in 57 patients (47%). A major complication occurred in 23 patients (18%). 19 patients had a TORS related major complication and 6 patients experienced a non-TORS related major complication. There was a temporal trend in TORS related major complication rate decreasing from 33% in 2010 to 10% in 2015.Statistical analysis showed that the odds of having any complication were 3 times greater in patients over 60years old (p=0.017), and 2.5 times greater when there were more than 2 subsites resected (p=0.022).ConclusionsAge over 60years and a larger extent of resection were the significant factors predictive of major complications.



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