Evaluation of anesthesia and reanimation in transoral robotic surgery
Bedih Balkan1, Aycan Güner Ekici1, Gülsüm Oya Hergünsel1, Ipek Bostancı1, Arzu Karaman Koç2, Hasan Emre Koçak2, Fatma Tülin Kayhan2
1Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Anestezi ve Reanimasyon Kliniği, İstanbul, Türkiye
2Bakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi Kulak Burun Boğaz Kliniği, İstanbul, Türkiye
Keywords: Follow-up, reanimation, robotic, surgery, transoral.
Abstract
OBJECTIVE: This study aims to evaluate the differences in the anesthesia method used according to anatomical location of the disease and patients' antecedent diseases, intra- and postoperative complications and their solutions in patients who were performed transoral robotic surgery (TORS) due to oral cavity, pharyngeal and laryngeal benign and/or malign pathology.
METHODS: Anesthesia records of 52 patients (39 males, 13 females; mean age 58±14 years; range, 30 to 85 years) who were performed TORS in Bakırköy Dr. Sadi Konuk Training and Research Hospital Ear Nose Throat Clinic due to benign or malignant upper respiratory pathology were retrospectively reviewed. Patients’ demographic information, anatomical location of disease, antecedent diseases, American Society of Anesthesiologists scores and perioperative findings, used anesthesia methods, postoperative pain levels, intra- or postoperatively developing anesthesia complications and their solutions were evaluated.
RESULTS: Of the 52 patients who were performed TORS, eight were performed mass resection due to benign neoplasm of the larynx, 13 were performed supraglottic laryngectomy due to supraglottic squamous cell carcinoma (SCC), 17 were performed cordectomy due to vocal SCC, six were performed radical tonsillectomy due to tonsil tumor, four were performed tongue root resection due to tongue root SCC; two were performed tumor resection from oral cavity, and two were performed hypopharyngectomy due to hypopharynx SCC. Mean duration of anesthesia was 112.62 minutes, mean duration of robotic surgery including robotic tool set-up was 89.38 minutes. Three patients required analgesic postoperatively. Two patients were performed peroperative and one patient was performed postoperative tracheostomy. Two patients were taken under operation preoperatively tracheostomized. Six patients were performed prolonged intubation. No blood transfusion was needed in any patient.
CONCLUSION: The frequency of performing TORS increases due to low morbidity rates and surgical superiorities. Coordination of the anesthesia and surgical teams is important for a safer TORS.