Airway management during transoral robotic surgery for head and neck cancers: a French GETTEC group survey

Poissonnet, Valentine; Chabrillac, Emilien; Schultz, P.; Morinière, S.; Gorphe, Philippe; Baujat, B.; Garrel, R.; Lasne-Cardon, Audrey; Villeneuve, A.; Chambon, Guillaume; Fakhry, Nicolas; Aubry, Karine; Dufour, Xavier; Malard, O.; Mastronicola, Romina; Vairel, B.; Gallet, P.; Céruse, Philippe; Jégoux, Franck; Van, J. Ton; Bonnecaze, Guillaume de; Vergez, S.

doi:10.1007/s00405-021-07188-4

Cited by 7 publications

(3 citation statements)

References 35 publications

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“…The risk of adverse airway events due to pharyngolaryngeal edema is low following TORS. 46 Indeed, less than 1% of patients in the recent randomized E3311 trial suffered a grade 3 Clavien-Dindo complication secondary to laryngeal edema. 47 Some patients still are at high risk of airway compromise following TORS, and delayed extubation has demonstrated benefit for short-term airway protection in TORS patients among small single-center studies.…”

Section: Transoral Robotic Surgerymentioning

confidence: 99%

Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations

Cleere,

Read,

Prunty

et al. 2024

Head & Neck

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Major head and neck surgery poses a threat to perioperative airway patency. Adverse airway events are associated with significant morbidity, potentially leading to hypoxic brain injury and even death. Following a review of the literature, recommendations regarding airway management in head and neck surgery were developed with multicenter, multidisciplinary agreement among all Irish head and neck units. Immediate extubation is appropriate in many cases where there is a low risk of adverse airway events. Where a prolonged definitive airway is required, elective tracheostomy provides increased airway security postoperatively while delayed extubation may be appropriate in select cases to reduce postoperative morbidity. Local institutional protocols should be developed to care for a tracheostomy once inserted. We provide guidance on decision making surrounding airway management at time of head and neck surgery. All decisions should be agreed between the operating, anesthetic, and critical care teams.

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Section: Transoral Robotic Surgerymentioning

confidence: 99%

Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations

Cleere,

Read,

Prunty

et al. 2024

Head & Neck

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show abstract

“…Congestive heart failure, pulmonary disease, connective tissue diseases, morbid obesity, poorly controlled diabetes, immunosuppression, and malnutrition are considered as relative contraindications for surgery [ 4 , 13 ]. In addition to determining the patient’s operability, these comorbidities also weigh on the decision to perform a prophylactic tracheostomy [ 14 , 15 ].…”

Section: Preoperative Considerations and Eligibility Criteriamentioning

confidence: 99%

“…Indeed, TORS for HNC does not systematically require a tracheostomy. According to a French expert survey, high-risk situations such as previous radiation therapy with residual edema or anticoagulation therapy with large resections might be indications for preventive tracheostomy [ 14 , 15 ].…”

Section: Postoperative Course and Complicationsmentioning

confidence: 99%

Transoral Robotic Surgery for Head and Neck Cancer: Advances and Residual Knowledge Gaps

Mella

Chabrillac

Dupret‐Bories

et al. 2023

JCM

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Minimally invasive surgery is a growing field in surgical oncology. After acquiring its first Food and Drug Administration approval in 2009 for T1–T2 malignancies of the oral cavity, oropharynx, and larynx, transoral robotic surgery (TORS) has gained popularity thanks to its wristed instruments and magnified three-dimensional view, enhancing surgical comfort in remote-access areas. Its indications are expanding in the treatment of head and neck cancer, i.e., resection of tumors of the larynx, hypopharynx, or parapharyngeal space. However, this expansion must remain cautious and based on high-level evidence, in order to guarantee safety and oncological outcomes which are comparable to conventional approaches. This narrative review assesses the current role of TORS in head and neck cancer from an evidence-based perspective, and then identifies what knowledge gaps remain to be addressed.

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Complications including dysphagia following transoral non-robotic surgery for pharyngeal and laryngeal squamous cell carcinoma: A retrospective multicenter study

Ushiro,

Watanabe,

Kishimoto

et al. 2024

Auris Nasus Larynx

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Airway management during transoral robotic surgery for head and neck cancers: a French GETTEC group survey

Cited by 7 publications

References 35 publications

Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations

Airway decision making in major head and neck surgery: Irish multicenter, multidisciplinary recommendations

Transoral Robotic Surgery for Head and Neck Cancer: Advances and Residual Knowledge Gaps

Complications including dysphagia following transoral non-robotic surgery for pharyngeal and laryngeal squamous cell carcinoma: A retrospective multicenter study

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