(A501) A National Database Study on Deep Vein Thrombosis Prophylaxis in Transoral Robotic Surgery

Monday, October 13, 2025

12:00 PM - 1:00 PM EDT

Location: OTO EXPO, Posters

Presenting Author(s)

Shahrukh R. Ali, MD

Resident
University of Texas Medical Branch Hospitals
Richmond, TX, United States

Co-Author(s)

Robert E. Africa, MD

Resident
University of Texas Medical Branch Hospitals
Galveston, TX, United States
Amber M. Dunmire, MD

Resident
University of Texas Medical Branch Hospitals
Galveston, TX, United States
Sepehr Shabani, MD

Assistant Professor
City of Hope National Medical Center
Duarte, California, United States
Orly M. Coblens, MD

Associate Professor & Residency Program Director
University of Texas Medical Branch Hospitals
Galveston, Texas, United States

Senior Author(s)

Viran J. Ranasinghe, MD

Assistant Professor
University of Texas Medical Branch
Galveston, TX, United States

Disclosure(s):

Shahrukh Ali, MD: No relevant relationships to disclose.

Sepehr Shabani, MD: No relevant relationships to disclose.

Orly M. Coblens, MD: No relevant relationships to disclose.

Viran J. Ranasinghe, MD: No relevant relationships to disclose.

Introduction: This study aims to evaluate and compare outcomes between patients who received deep vein thrombosis (DVT) prophylaxis and those who did not after undergoing transoral robotic surgery (TORS), focusing on the postoperative period.

Methods: This multicenter retrospective cohort study utilized de-identified patient data from 68 healthcare organizations in the TriNetX database across the United States, spanning from January 1, 2010, to January 1, 2024. Patients aged 18 years r older who underwent TORS were included. Outcomes were compared between those who received DVT prophylaxis and those who did not within 1 to 30 days post-surgery. Primary outcomes assessed were postoperative bleeding requiring hemorrhage control and the need for tracheostomy. Outcome rates were measured using relative risk (RR) with a 95% confidence interval (CI).

Results: After propensity score matching, 23,296 patients were analyzed. The comparison revealed significant differences in postoperative outcomes. The group that received DVT prophylaxis had a higher risk of postoperative hemorrhage requiring operative intervention (RR: 0.27; 95% CI: 0.129-0.412). Additionally, the incidence of tracheostomy was elevated in the DVT prophylaxis group (RR: 0.631; 95% CI: 0.499-0.763).

Conclusions: The findings indicate that DVT prophylaxis in the postoperative period following TORS may be associated with an increased risk of postoperative hemorrhage requiring operative control and an elevated incidence of tracheostomy. This suggests that clinicians should use DVT prophylaxis with caution in patients with increased risks of bleeding following TORS.