Evolution of neck dissections performed in conjunction with transoral robotic surgery lateral oropharyngectomy

Krishnan, Giri; David, Rowan; Gouzos, Michael; Foreman, Andrew; Krishnan, Suren; Hodge, John-Charles

doi:10.21037/ajo.2018.01.09

Cited by 6 publications

(33 citation statements)

References 30 publications

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“…Due to the relative rarity of arterial (major/severe) postoperative bleeding following TORS, most results from the individual studies did not reach statistical significance; however, there appears to be a consistent trend toward a reduction in major/severe bleeding with prophylactic arterial ligation of the feeding vessels . The results of our meta‐analysis support this.…”

Section: Discussionmentioning

confidence: 51%

“…Overall, the incidence of hemorrhage following TORS has been reported to be as high as 18.5% . However, major and severe bleeding occurs much less frequently, with rates of 2% to 6% in the retrospective series included in our analysis . A variety of clinical factors have been shown to be associated with an increased risk of bleeding including recurrent tumors, use of anticoagulant/antiplatelet medications, tonsil subsite, higher comorbidity scores, and surgeon experience .…”

Section: Discussionmentioning

confidence: 85%

“…Potential complications of arterial ligation that have been proposed in the literature include: poor wound healing, fistula, impaired response to RT, as well as first bite syndrome . In the four retrospective reviews included in our analysis as well as the review by Pollei et al, no reported complications from prophylactic arterial ligation occurred . However, particularly with first bite syndrome, since investigators were not necessarily assessing for this complication, its true incidence is likely underestimated.…”

Section: Discussionmentioning

confidence: 88%

“…Full text review stage excluded two additional studies. After all exclusions four retrospective cohort studies remained for analysis (Figure ), which included three from the United States and one from Australia . Table details the severity of postoperative bleeding of patients in each study.…”

Section: Resultsmentioning

confidence: 99%

“…This difference was not statistically significant. There were no complications reported from arterial ligation …”

Section: Discussionmentioning

confidence: 97%

See 4 more Smart Citations

Prophylactic arterial ligation following transoral robotic surgery: A systematic review and meta‐analysis

Bollig¹,

Gilley

Ahmad

et al. 2019

Head & Neck

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Prophylactic arterial ligation has been proposed to reduce the severity of postoperative hemorrhage following transoral robotic surgery (TORS). Previous studies have shown a trend toward a reduction in major and severe bleeding. Search strategies were implemented in multiple databases and completed in August 2018. Inclusion and exclusion criteria were designed to capture studies examining adults undergoing TORS for oropharyngeal cancer. Four retrospective studies were selected appropriate for analysis by two reviewers who independently extracted data. PRISMA guidelines were followed. A random‐effects model was used for meta‐analysis. Meta‐analysis of 619 patients in four retrospective reviews showed that the pooled RR of major and severe bleeding events was significantly lower in prophylactically ligated patients (RR, 0.28; 95% CI, 0.08‐0.92; I2 = 0). Prophylactic arterial ligation of external carotid artery branches is associated with a decreased risk of major and severe bleeding events, although confounding factors remain incompletely analyzed.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 88%

Section: Resultsmentioning

confidence: 99%

“…This difference was not statistically significant. There were no complications reported from arterial ligation …”

Section: Discussionmentioning

confidence: 97%

See 3 more Smart Citations

Prophylactic arterial ligation following transoral robotic surgery: A systematic review and meta‐analysis

Bollig¹,

Gilley

Ahmad

et al. 2019

Head & Neck

View full text Add to dashboard Cite

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Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta‐analysis

et al. 2020

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Background: Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS). Methods: A systematic review of English-language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta-analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage. Results: Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, P = .02) and advanced tumor stage (OR = 1.93, P = .02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, P = .03) and in the TORS-only subgroup (OR = 0.21, P = .02), but did not significantly impact overall odds of postoperative hemorrhage. Conclusion: Transcervical arterial ligation offers protection against major/ severe postoperative hemorrhage in patients undergoing TORS.

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Staged neck dissection prior to transoral robotic surgery for oropharyngeal cancer: does it reduce post-operative complication rates? A multi-centre study of 104 patients

Blom

Zhang

Tescher

et al. 2023

Eur Arch Otorhinolaryngol

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Evolution of neck dissections performed in conjunction with transoral robotic surgery lateral oropharyngectomy

Cited by 6 publications

References 30 publications

Prophylactic arterial ligation following transoral robotic surgery: A systematic review and meta‐analysis

Prophylactic arterial ligation following transoral robotic surgery: A systematic review and meta‐analysis

Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta‐analysis

Staged neck dissection prior to transoral robotic surgery for oropharyngeal cancer: does it reduce post-operative complication rates? A multi-centre study of 104 patients

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