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

Autor: Sharbel DD; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Abkemeier M; Medical College of Georgia, Augusta University, Augusta, Georgia, USA., Sullivan J; Medical College of Georgia, Augusta University, Augusta, Georgia, USA., Zimmerman Z; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Albergotti WG; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA., Duvvuri U; Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA., Byrd JK; Department of Otolaryngology-Head and Neck Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2021 Jan; Vol. 43 (1), pp. 334-344. Date of Electronic Publication: 2020 Sep 25.
DOI: 10.1002/hed.26480
Abstrakt: 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.
(© 2020 Wiley Periodicals LLC.)
Databáze: MEDLINE
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