Spondylodiscitis after transoral robotic surgery: Retrospective 7-case series from the GETTEC group.
Cervical spondylodiscitis
Pharyngeal tumor
Robotic surgery
Spondylodiscitis
TORS
Transoral robotic surgery
Journal
European annals of otorhinolaryngology, head and neck diseases
ISSN: 1879-730X
Titre abrégé: Eur Ann Otorhinolaryngol Head Neck Dis
Pays: France
ID NLM: 101531465
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
pubmed:
25
3
2019
medline:
27
12
2019
entrez:
26
3
2019
Statut:
ppublish
Résumé
Cervical spondylodiscitis is a rare but severe complication of pharyngeal surgery. This multicenter retrospective study reported all patients in the database of the French head and neck tumor study group (GETTEC) affected by cervical spondylodiscitis after transoral robotic surgery (TORS) for malignant pharyngeal tumor from January 2010 to January 2017. To describe cases of post-TORS cervical spondylodiscitis, identify alarm signs, and determine optimal management of these potentially lethal complications. Seven patients from 6 centers were included. Carcinomas were located in the posterior pharyngeal wall. Tumor stage was T1 or T2. All patients had risk factors for spondylodiscitis. Mean time to diagnosis was 12.6days. The interval between surgery and spondylodiscitis diagnosis ranged from 20days to 4.5months, for a mean 2.1months. The most common symptom was neck pain (87%). Infections were polymicrobial; micro-organisms were isolated in 5 cases and managed by intravenous antibiotics, associated to medullary decompression surgery in 3 cases. Follow-up found favorable progression in 4 cases, and 3 deaths (mortality, 43%). This French multicenter study found elevated mortality in post-TORS spondylodiscitis, even in case of limited resection. Surgeons must be aware of this complication and alerted by persistent neck pain, fever, asthenia, impaired or delayed posterior pharyngeal wall wound healing or elevation of inflammatory markers. MRI is the most effective diagnostic radiological examination.
Sections du résumé
BACKGROUND
BACKGROUND
Cervical spondylodiscitis is a rare but severe complication of pharyngeal surgery.
MATERIAL AND METHODS
METHODS
This multicenter retrospective study reported all patients in the database of the French head and neck tumor study group (GETTEC) affected by cervical spondylodiscitis after transoral robotic surgery (TORS) for malignant pharyngeal tumor from January 2010 to January 2017.
OBJECTIVES
OBJECTIVE
To describe cases of post-TORS cervical spondylodiscitis, identify alarm signs, and determine optimal management of these potentially lethal complications.
RESULTS
RESULTS
Seven patients from 6 centers were included. Carcinomas were located in the posterior pharyngeal wall. Tumor stage was T1 or T2. All patients had risk factors for spondylodiscitis. Mean time to diagnosis was 12.6days. The interval between surgery and spondylodiscitis diagnosis ranged from 20days to 4.5months, for a mean 2.1months. The most common symptom was neck pain (87%). Infections were polymicrobial; micro-organisms were isolated in 5 cases and managed by intravenous antibiotics, associated to medullary decompression surgery in 3 cases. Follow-up found favorable progression in 4 cases, and 3 deaths (mortality, 43%).
CONCLUSION
CONCLUSIONS
This French multicenter study found elevated mortality in post-TORS spondylodiscitis, even in case of limited resection. Surgeons must be aware of this complication and alerted by persistent neck pain, fever, asthenia, impaired or delayed posterior pharyngeal wall wound healing or elevation of inflammatory markers. MRI is the most effective diagnostic radiological examination.
Identifiants
pubmed: 30905532
pii: S1879-7296(19)30047-X
doi: 10.1016/j.anorl.2019.03.004
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
179-183Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.