TY - JOUR

T1 - Why in hospital following transoral robotic lingual tonsillectomy?

AU - Larsen, Mikkel Hjordt Holm

AU - Channir, Hani Ibrahim

AU - Madsen, Anne Kathrine Østergaard

AU - Rubek, Niclas

AU - O’Leary, Padraig

AU - Kjærgaard, Thomas

AU - Kehlet, Henrik

AU - von Buchwald, Christian

N1 - Publisher Copyright: © 2023 Acta Oto-Laryngologica AB (Ltd).

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - hospitalization

KW - recovery

KW - Transoral robotic surgery

U2 - 10.1080/00016489.2023.2265983

DO - 10.1080/00016489.2023.2265983

M3 - Journal article

C2 - 37897327

AN - SCOPUS:85175046266

VL - 143

SP - 796

EP - 800

JO - Acta Oto-Laryngologica

JF - Acta Oto-Laryngologica

SN - 0001-6489

IS - 9

ER -