Stephanie Wong, Liyang Tang, Daniel Kwon, Mark Swanson, Niels C Kokot, Uttam K Sinha, Albert Y Han
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Preoperative risk factors were collected. The primary outcomes were 30-day readmission, reoperation, hemorrhage, and death. Univariate and multivariate analysis was used to identify preoperative risk factors associated with the primary outcomes.</p><p><strong>Results: </strong>The mean age was 60.6 years, and 81.5% were male. There were 24 deaths (0.7% 30-day mortality rate). The rates of readmission and reoperation were 8.9% and 5.8%, respectively. Smoking (OR = 1.440, 95% CI = 1.097-1.890) and CHF (OR = 3.525, 95% CI = 1.320-9.414) were associated with readmission. Diabetes and ASA 3+ increased the risk of both reoperation (diabetes: OR = 2.679, 95% CI = 1.110-6.468, ASA: OR = 1.701, 95% CI = 1.233-2.346) and hemorrhage (diabetes: OR = 3.488, 95% CI = 1.020-11.926, ASA: OR = 2.290, 95% CI = 1.394-3.764).</p><p><strong>Conclusion: </strong>This study redemonstrated the safety of TOS for OPSCC, with low 30-day readmission and reoperation rates. 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Although the 30-day mortality and morbidity remain low, understanding the risk factors associated with complications is still required. The goal of this study is to identify risk factors associated with complications after TOS for OPSCC using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.</p><p><strong>Methods: </strong>A multi-institutional retrospective cohort analysis of the ACS-NSQIP database identified 3,489 patients undergoing TOS for OPSCC between 2010 and 2021. Preoperative risk factors were collected. The primary outcomes were 30-day readmission, reoperation, hemorrhage, and death. Univariate and multivariate analysis was used to identify preoperative risk factors associated with the primary outcomes.</p><p><strong>Results: </strong>The mean age was 60.6 years, and 81.5% were male. There were 24 deaths (0.7% 30-day mortality rate). The rates of readmission and reoperation were 8.9% and 5.8%, respectively. Smoking (OR = 1.440, 95% CI = 1.097-1.890) and CHF (OR = 3.525, 95% CI = 1.320-9.414) were associated with readmission. Diabetes and ASA 3+ increased the risk of both reoperation (diabetes: OR = 2.679, 95% CI = 1.110-6.468, ASA: OR = 1.701, 95% CI = 1.233-2.346) and hemorrhage (diabetes: OR = 3.488, 95% CI = 1.020-11.926, ASA: OR = 2.290, 95% CI = 1.394-3.764).</p><p><strong>Conclusion: </strong>This study redemonstrated the safety of TOS for OPSCC, with low 30-day readmission and reoperation rates. 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引用次数: 0
摘要
目的：先前的研究强调了因口咽鳞状细胞癌（OPSCC）接受经口手术（TOS）的患者因灾难性出血而围手术期死亡的风险。尽管30天死亡率和发病率仍然很低，但仍需要了解与并发症相关的危险因素。本研究的目的是利用美国外科医师学会国家手术质量改进计划（ACS-NSQIP）数据库，确定与OPSCC手术后TOS并发症相关的危险因素。方法：对ACS-NSQIP数据库进行多机构回顾性队列分析，确定了2010年至2021年期间接受TOS治疗的3,489例OPSCC患者。收集术前危险因素。主要结局为30天再入院、再手术、出血和死亡。采用单因素和多因素分析确定与主要结局相关的术前危险因素。结果：平均年龄60.6岁，男性占81.5%。死亡24例（30天死亡率0.7%）。再入院率为8.9%，再手术率为5.8%。吸烟（OR = 1.440, 95% CI = 1.097-1.890）和瑞士法郎（OR = 3.525, 95% CI = 1.320-9.414）与再入院相关。糖尿病和ASA 3+增加了再手术（糖尿病：OR = 2.679, 95% CI = 1.110 ~ 6.468, ASA: OR = 1.701, 95% CI = 1.233 ~ 2.346）和出血（糖尿病：OR = 3.488, 95% CI = 1.020 ~ 11.926, ASA: OR = 2.290, 95% CI = 1.394 ~ 3.764）的风险。结论：本研究再次证明了TOS治疗OPSCC的安全性，具有较低的30天再入院和再手术率。吸烟、糖尿病、CHF和ASA 3+是术前并发症的重要危险因素。证据等级：3：喉镜，2025。
Complications After Transoral Surgery for Oropharyngeal Cancer: An ACS-NSQIP Database Study.
Objective: Prior studies have highlighted the risk of perioperative mortality due to catastrophic bleeding in patients receiving transoral surgery (TOS) for oropharyngeal squamous cell carcinoma (OPSCC). Although the 30-day mortality and morbidity remain low, understanding the risk factors associated with complications is still required. The goal of this study is to identify risk factors associated with complications after TOS for OPSCC using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database.
Methods: A multi-institutional retrospective cohort analysis of the ACS-NSQIP database identified 3,489 patients undergoing TOS for OPSCC between 2010 and 2021. Preoperative risk factors were collected. The primary outcomes were 30-day readmission, reoperation, hemorrhage, and death. Univariate and multivariate analysis was used to identify preoperative risk factors associated with the primary outcomes.
Results: The mean age was 60.6 years, and 81.5% were male. There were 24 deaths (0.7% 30-day mortality rate). The rates of readmission and reoperation were 8.9% and 5.8%, respectively. Smoking (OR = 1.440, 95% CI = 1.097-1.890) and CHF (OR = 3.525, 95% CI = 1.320-9.414) were associated with readmission. Diabetes and ASA 3+ increased the risk of both reoperation (diabetes: OR = 2.679, 95% CI = 1.110-6.468, ASA: OR = 1.701, 95% CI = 1.233-2.346) and hemorrhage (diabetes: OR = 3.488, 95% CI = 1.020-11.926, ASA: OR = 2.290, 95% CI = 1.394-3.764).
Conclusion: This study redemonstrated the safety of TOS for OPSCC, with low 30-day readmission and reoperation rates. Smoking, diabetes, CHF, and ASA 3+ were important preoperative risk factors for complications.
期刊介绍：
The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope.
• Broncho-esophagology
• Communicative disorders
• Head and neck surgery
• Plastic and reconstructive facial surgery
• Oncology
• Speech and hearing defects
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