Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta-analysis

Daniel D. Sharbel; Mary Abkemeier; James Sullivan; Zach Zimmerman; William G. Albergotti; Umamaheswar Duvvuri; James Kenneth Byrd

doi:10.1002/hed.26480

Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta-analysis

Daniel D. Sharbel, Mary Abkemeier, James Sullivan, Zach Zimmerman, William G. Albergotti, Umamaheswar Duvvuri, James Kenneth Byrd

Otolaryngology

Research output: Contribution to journal › Review article › peer-review

12 Scopus citations

Abstract

Background: Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS). Methods: A systematic review of English-language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta-analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage. Results: Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, P =.02) and advanced tumor stage (OR = 1.93, P =.02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, P =.03) and in the TORS-only subgroup (OR = 0.21, P =.02), but did not significantly impact overall odds of postoperative hemorrhage. Conclusion: Transcervical arterial ligation offers protection against major/severe postoperative hemorrhage in patients undergoing TORS. Level of Evidence: II.

Original language	English (US)
Pages (from-to)	334-344
Number of pages	11
Journal	Head and Neck
Volume	43
Issue number	1
DOIs	https://doi.org/10.1002/hed.26480
State	Published - Jan 2021

Keywords

arterial ligation
oropharyngeal hemorrhage
oropharyngectomy
postoperative hemorrhage
transoral robotic surgery

ASJC Scopus subject areas

Otorhinolaryngology

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10.1002/hed.26480

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title = "Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta-analysis",

abstract = "Background: Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS). Methods: A systematic review of English-language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta-analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage. Results: Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, P =.02) and advanced tumor stage (OR = 1.93, P =.02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, P =.03) and in the TORS-only subgroup (OR = 0.21, P =.02), but did not significantly impact overall odds of postoperative hemorrhage. Conclusion: Transcervical arterial ligation offers protection against major/severe postoperative hemorrhage in patients undergoing TORS. Level of Evidence: II.",

keywords = "arterial ligation, oropharyngeal hemorrhage, oropharyngectomy, postoperative hemorrhage, transoral robotic surgery",

author = "Sharbel, {Daniel D.} and Mary Abkemeier and James Sullivan and Zach Zimmerman and Albergotti, {William G.} and Umamaheswar Duvvuri and Byrd, {James Kenneth}",

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doi = "10.1002/hed.26480",

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AU - Abkemeier, Mary

AU - Sullivan, James

AU - Zimmerman, Zach

AU - Albergotti, William G.

AU - Duvvuri, Umamaheswar

AU - Byrd, James Kenneth

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N2 - Background: Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS). Methods: A systematic review of English-language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta-analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage. Results: Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, P =.02) and advanced tumor stage (OR = 1.93, P =.02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, P =.03) and in the TORS-only subgroup (OR = 0.21, P =.02), but did not significantly impact overall odds of postoperative hemorrhage. Conclusion: Transcervical arterial ligation offers protection against major/severe postoperative hemorrhage in patients undergoing TORS. Level of Evidence: II.

AB - Background: Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS). Methods: A systematic review of English-language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta-analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage. Results: Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, P =.02) and advanced tumor stage (OR = 1.93, P =.02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, P =.03) and in the TORS-only subgroup (OR = 0.21, P =.02), but did not significantly impact overall odds of postoperative hemorrhage. Conclusion: Transcervical arterial ligation offers protection against major/severe postoperative hemorrhage in patients undergoing TORS. Level of Evidence: II.

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KW - oropharyngectomy

KW - postoperative hemorrhage

KW - transoral robotic surgery

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Transcervical arterial ligation for prevention of postoperative hemorrhage in transoral oropharyngectomy: Systematic review and meta-analysis

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