Why in hospital following transoral robotic lingual tonsillectomy?

Acta Otolaryngol. 2023 Sep;143(9):796-800. doi: 10.1080/00016489.2023.2265983. Epub 2023 Nov 8.

Abstract

Background: The reported hospital length of stay (LOS) following transoral robotic surgery lingual tonsillectomy (TORS-L) is variable, with limited understanding of the factors requiring hospitalization and no evidence-based criteria for discharge.

Aims/objectives: This observational cohort study investigated factors hindering discharge following TORS-L in a well-defined postoperative care program.

Methods: Patients were included between August 2020 and October 2022. A discharge scheme was filled out twice daily, specifying the factor(s) for hospitalization among patients undergoing TORS-L. This trial was a sub-investigation of a national multicentre randomized clinical trial (RCT) testing the efficiency of high-dose dexamethasone on postoperative pain control. Participation in the RCT demanded admission to the fourth postoperative day as dexamethasone/placebo was given intravenously in repeated dosages till day 4 postoperatively.

Results: Eighteen patients were included in the analysis. The main factor for hospitalization was nutritional difficulties, while pain was a limiting factor for discharge only on the first postoperative 1-3 days. More than half of the patients could have potentially been discharged on postoperative day 2 when omitting the RCT treatment plan in the analysis.

Conclusion: The study estimates that the majority of patients may be discharged on postoperative day 2 following TORS-L.

Keywords: Transoral robotic surgery; hospitalization; recovery.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study
  • Observational Study

MeSH terms

  • Dexamethasone
  • Hospitals
  • Humans
  • Robotic Surgical Procedures*
  • Tonsillectomy*
  • Treatment Outcome

Substances

  • Dexamethasone