Journal of Anesthesia and SurgeryJournal of Anesthesia and SurgeryJournal of Anesthesia and SurgeryJournal of Anesthesia and Surgery2377-1364Ommega Online PublishersNew Jersey, USA129210.15436/2377-1364.17.062Research ArticleManagement of the Airway in Transoral Robotic Surgery for Head and Neck CancerManagement of the Airway in Transoral Robotic Surgery for Head and Neck CancerJoseGranell 1Department of Otorhinolaryngology Rey Juan Carlos University Hospital Madrida 2Department of Anesthesiology Rey Juan Carlos University Hospital Madrid 3Intensive Care Unit Rey Juan Carlos University Hospital Madrid Editor* E-mail: jose.granell@hospitalreyjuancarlos.es
The authors have declared that no competing interests exist.
20172601201741JAS-16-RA-129230122016200120172017Creative Commons Attribution LicenseThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. nbsp Aim of the study To evaluate the safety and effectiveness of a conservative management of the airway without tracheotomy in a new transoral robotic surgery program for head and neck cancer Materials and Method Observational prospective study on a cohort without a control group We included patients diagnosed of oropharyngeal hypopharyngeal or laryngeal cancer who underwent transoral robotic surgery between July 2013 and July 2016 Results Thirty-six patients met the inclusion criteria 72 were oropharyngeal tumors most frequently 13 cases tumors of the base of the tongue The most frequent local extension was T2 18 cases but almost two-thirds 64 were classified as advanced tumors stages III and IV due to the N stage Lymph node surgery and transoral primary tumor surgery were staged when required The intervention was successful in all cases After robotic surgery the patients in risk remained intubated for 24 hours All were managed without a tracheostomy except for a patient with a synchronous diagnosis of sleep apnea who received a temporary prophylactic tracheostomy and a case of combined transoral-transcervical surgery who received a non-programmed tracheotomy There were no relevant perioperative incidences related to the airway except for a case of delayed bleeding Conclusions In our early experience with a conservative management protocol with two-stage surgery and programmed postoperative intubation transoral robotic surgery for oncological indications has been feasible and safe without a tracheotomy 10