A National Database Analysis of Safety Outcomes in Transoral Robotic Surgery

Monday, October 13, 2025

3:24 PM - 3:30 PM EDT

Location: 127

Disclosure(s):

Ashton Huppert Steed, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Brent A. Chang, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Transoral robotic surgery (TORS) is a minimally invasive means of surgically treating aerodigestive tract malignancies. Mortality rates associated with TORS, as reported in prospective trials, range from 0% to 8%, and TORS-related mortality has been a criticism of these studies and TORS in general. This study aims to refine the understanding of TORS-related mortality and safety outcomes by analyzing recent national data.

Methods: The National Surgical Quality Improvement Program (NSQIP) database was reviewed for adult patients who underwent TORS from 2022-2023. Patient demographics, postoperative complications, and 30-day mortality rates were analyzed and compared to TORS clinical trials.

Results: A total of 410 patients who underwent TORS were included for analysis. The 30-day mortality rate was 0.73% (3/410). The overall postoperative complication rate was 15.4%, and the rate of complications including death, readmission, reoperation, or prolonged ventilation was 12.7%. Prospective trials reported deaths in two of the three studies. The studies showed deaths in 1 of 34, 2 of 25, and 0 of 219 patients, for a cumulative mortality rate of 1.08% (3/278).

Conclusions: Mortality remains a major criticism of TORS. While absolute numbers of deaths have been low, TORS trials have not necessarily addressed this criticism. Here we show when using a national database, 30-day mortality amongst TORS patients remains low ( < 1%). Furthermore we show that, taken together, prospective trials also demonstrate low mortality (1.08%). Moreover, our analysis shows that TORS mortality is comparable to rates reported in the literature for other head and neck operations such as total laryngectomy, or free flap operations. Ultimately, these findings underscore the safety of TORS.

Presenting Author(s)

Ashton Huppert Steed, BS

Medical Student
University of Arizona College of Medicine Phoenix
Gilbert, AZ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

GJ

Gaurav A. Jategaonkar

Medical Student
Mayo Clinic Alix School of Medicine in Arizona
Phoenix, AZ, United States

Disclosure information not submitted.
JH

Justin M. Hintze, MD

Mayo Clinic Arizona
Phoenix, Arizona, United States

Disclosure information not submitted.
Deborah X. Xie, MD

Fellow
Indiana University School of Medicine
Phoenix, AZ, United States

Disclosure information not submitted.
BC

Brent A. Chang, MD

Associate Professor
Mayo Clinic Arizona
Phoenix, AZ, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Senior Author(s)

AJ

Ameya A. Jategaonkar, MD

Assistant Professor, Director - Division of Advanced Oncologic and Reconstructive Surgery
Barrow Neurological Institute Department of Otolaryngology and Skull Base Surgery
Phoenix, AZ, United States

Disclosure information not submitted.