A case of severe delayed hemorrhage after salvage transoral surgery for recurrent oropharyngeal cancer

Abstract

Transoral videolaryngoscopic surgery （TOVS） for pharyngeal and laryngeal cancer is a function-preserving surgery with low invasion and risk. However, it remains unclear whether TOVS is suitable as salvage surgery. We report a case that suffered severe postoperative hemorrhage after TOVS for recurrent tumor after chemo-radiotherapy despite the intention of minimally invasive salvage surgery. A 68-year-old man underwent TOVS due to T1 recurrent oropharyngeal cancer of the anterior wall after 8 years of initial treatment by chemoradiotherapy. However, the patient suffocated from severe hemorrhage on the 16th postoperative day, requiring emergency tracheotomy in a hospital ward and hemostasis in an operat-ing room. He has been followed for 18 months after surgery with functional preservation and no disease. TOVS might be applicable for salvage treatment as well as initial treatment as a function-preserving surgery. However, because it can lead to life-threatening postoperative bleeding especially in cases after radiotherapy, careful case selection and surgical planning are necessary.