Trans-Oral Robotic Surgery (TORS) and Postoperative Hemorrhage: An Analysis of Risk Factors.

IF 3 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES
Andrea Migliorelli, Elia Biancoli, Marianna Manuelli, Alberto Caranti, Andrea Ciorba, Chiara Bianchini, Giuseppe Meccariello, Claudio Vicini
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引用次数: 0

Abstract

Background/Objectives: Postoperative hemorrhage is the most common complication after Trans-Oral Robotic Surgery (TORS) described in the literature. The aim of this study is to assess the presence of any risk factors that may impact postoperative bleeding. Methods: This was a retrospective study based on the analysis of patient data. Patients undergoing TORS procedures at the ENT Unit of Forlì Hospital from 2008 to 2022 for OSA (obstructive sleep apnea) or oncological disease and with a minimum follow-up of 30 days were included. The comorbidities analyzed were perioperative anticoagulant/antiplatelet therapy and clinicopathological features concerning the pathology. Total bleeding and severe bleeding (which required management in the operating room) were included. Results: A total of 414 patients (106 oncological TORS and 308 OSA TORS patients) were included. Post-TORS bleeding occurred in 47 cases (11.3%) and severe bleeding in 18 cases (4.3%). The pathology (oncology vs. OSA) treated with TORS did not represent a risk factor (p = 0.466). Antiplatelet intake represented an important risk factor (p = 0.002). Postoperative hemorrhage for oncological TORS occurred in 11.3% patients; of these, 6.6% had severe bleeding. Artery ligation during neck dissection prevented the risk of severe bleeding (p < 0.001). In TORS for OSA, postoperative hemorrhage was found in 11.4% cases, of which 3.6% were major bleeding. Neither the degree of OSA nor the association with other concurrent procedures were risk factors for postoperative bleeding in this study. Conclusions: Patients taking perioperative antiplatelet therapy have an almost 5-fold increased risk of developing postoperative bleeding. The pathology (oncology vs. OSA) does not influence the risk of bleeding. Prophylactic arterial ligation during neck dissection significantly decreases the risk of severe bleeding.

经口机器人手术(TORS)与术后出血:危险因素分析。
背景/目的:术后出血是经口机器人手术(TORS)后最常见的并发症。本研究的目的是评估可能影响术后出血的任何危险因素的存在。方法:回顾性分析患者资料。纳入2008年至2022年在Forlì医院耳鼻喉科因阻塞性睡眠呼吸暂停(OSA)或肿瘤疾病接受TORS手术的患者,随访时间至少为30天。分析合并症为围手术期抗凝/抗血小板治疗及与病理相关的临床病理特征。包括全出血和大出血(需在手术室处理)。结果:共纳入414例患者,其中肿瘤tor 106例,OSA tor 308例。术后出血47例(11.3%),重度出血18例(4.3%)。接受TORS治疗的病理(肿瘤vs. OSA)不代表危险因素(p = 0.466)。抗血小板摄入是一个重要的危险因素(p = 0.002)。肿瘤tor术后出血发生率为11.3%;其中,6.6%有严重出血。颈清扫术中动脉结扎可预防严重出血(p < 0.001)。在OSA的TORS中,术后出血占11.4%,其中大出血占3.6%。在本研究中,OSA的程度和与其他并发手术的关联都不是术后出血的危险因素。结论:围手术期接受抗血小板治疗的患者发生术后出血的风险增加了近5倍。病理(肿瘤vs. OSA)不影响出血的风险。颈淋巴结术中预防性动脉结扎可显著降低严重出血的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Personalized Medicine
Journal of Personalized Medicine Medicine-Medicine (miscellaneous)
CiteScore
4.10
自引率
0.00%
发文量
1878
审稿时长
11 weeks
期刊介绍: Journal of Personalized Medicine (JPM; ISSN 2075-4426) is an international, open access journal aimed at bringing all aspects of personalized medicine to one platform. JPM publishes cutting edge, innovative preclinical and translational scientific research and technologies related to personalized medicine (e.g., pharmacogenomics/proteomics, systems biology). JPM recognizes that personalized medicine—the assessment of genetic, environmental and host factors that cause variability of individuals—is a challenging, transdisciplinary topic that requires discussions from a range of experts. For a comprehensive perspective of personalized medicine, JPM aims to integrate expertise from the molecular and translational sciences, therapeutics and diagnostics, as well as discussions of regulatory, social, ethical and policy aspects. We provide a forum to bring together academic and clinical researchers, biotechnology, diagnostic and pharmaceutical companies, health professionals, regulatory and ethical experts, and government and regulatory authorities.
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