title: Complications following transoral robotic surgery (TORS): A detailed institutional review of complications.
abstract: To report the complications occurring following TORS and to identify the factors predictive of complications.
  
  
  
  Following IRB approval a retrospective analysis of all TORS operations at our institution was performed. Postoperative complications within 45days were collected and graded with the Clavien-Dindo system. Complications were categorized into groups: all complications, not related to TORS and TORS related. Unadjusted odds ratios were calculated to test association between patients with and without a complication.
  
  
  
  122 TORS operations were carried out between June 2010 and August 2015. 77% were male, with a median age of 57. There were 92 primary tumor resections, 10second head and neck primary resections, 13 salvage procedures and 7 other indications. Surgical resection involved 1, 2 or >3 sub-sites in 36%, 28% and 36% patients, respectively. Overall, there were 107 complications (66 TORS related, 41 non-TORS related) that occurred in 57 patients (47%). A major complication occurred in 23 patients (18%). 19 patients had a TORS related major complication and 6 patients experienced a non-TORS related major complication. There was a temporal trend in TORS related major complication rate decreasing from 33% in 2010 to 10% in 2015. Statistical analysis showed that the odds of having any complication were 3 times greater in patients over 60years old (p=0.017), and 2.5 times greater when there were more than 2 subsites resected (p=0.022).
  
  
  
  Age over 60years and a larger extent of resection were the significant factors predictive of major complications.
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Hay
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Migliacci
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Daniella
authors.initials: D
authors.lastname: Karassawa Zanoni
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Jay O
authors.initials: JO
authors.lastname: Boyle
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Bhuvanesh
authors.initials: B
authors.lastname: Singh
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wong
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.affiliation: Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Electronic address: ganlyi@mskcc.org.
authors.forename: Ian
authors.initials: I
authors.lastname: Ganly
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects*
keywords: Complications; Oropharyngeal cancer; Postoperative care; Trans oral robotic surgery