Haemorrhage following transoral robotic surgery

Abstract

Background: To report our experience of postoperative haemorrhage in patients following transoral robotic surgery (TORS).

Methods: Data were collected on patients having TORS. Postoperative haemorrhage within 30 days was graded using the Mayo Clinic grading system.

Results: Transoral robotic surgery operations were performed on 122 patients. There were 23 bleeding events classified as minor to severe following 19 operations (16%). Haemorrhage requiring a return to the operating room occurred after 7 operations (6%). The odds of an emergent haemorrhage were 5.19 times greater in patients who had a staged neck dissection after TORS (P = .05). The odds of a postoperative bleeding event were 2.6 times greater in patients receiving a larger resection (P = .107). There were no haemorrhage events in the 36 patients who received a synchronous neck dissection with transcervical ligation of the external carotid artery.

Conclusions: Surgical intervention for TORS haemorrhage occurred in 6% patients. No haemorrhage occurred in patients who had ligation of the external carotid artery.

Keywords: complications; haemorrhage; predictors; robotic; transoral robotic surgery.

© 2017 John Wiley & Sons Ltd.

Figures

Figure 1

Graph showing the distribution of hemorrhage events by post-operative day and the timing procedures to arrest hemorrhage

Figure 2

Graph showing the percentage of hemorrhage and emergent events over time