Postoperative bleeding in transoral laser microsurgery for upper aerodigestive tract tumors

• Published in: Otolaryngology-head and neck surgery 2008-09, Vol.139 (3), p.453-459
• Main Authors: Salassa, John R., Hinni, Michael L., Grant, David G., Hayden, Richard E.
• Format: Article
• Language: English
• Subjects: Adult; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Electrocoagulation; Fatal Outcome; Female; Humans; Hypopharyngeal Neoplasms - radiotherapy; Hypopharyngeal Neoplasms - surgery; Incidence; Laryngeal Neoplasms - surgery; Larynx - blood supply; Laser Therapy; Male; Microsurgery; Oropharynx - blood supply; Pharyngeal Neoplasms - surgery; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - surgery; Risk Factors; Salvage Therapy; Tongue Neoplasms - surgery; Treatment Failure
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1016/j.otohns.2008.06.010

To report the incidence, cause, and outcome of bleeding after transoral laser microsurgery. A two-center prospective case series analysis. Seven hundred one patients underwent transoral laser microsurgery for tumors of the oral cavity, pharynx, and larynx from June 1996 through September 2006. Ten patients (1.4%) experienced postoperative bleeding between 0 and 17 days after surgery. Five patients had previously untreated tumors, and five patients had salvage surgery. Two patients (0.3%) had minor bleeding and required observation only. Five patients (0.7%) experienced major bleeding requiring exploration under general anesthesia. Three patients (0.4%) had catastrophic life-threatening bleeds, two of whom died. The bleeding vessel was identified as the lingual artery in four patients, the superior laryngeal artery in two, the facial artery in two, and unknown in two. Bleeding after transoral laser microsurgery is rare but potentially life-threatening.