Transoral surgery is a minimally invasive treatment but may cause severe dysphagia at a lower rate than chemoradiotherapy. We compared clinical information, surgical complications, and swallowing function in patients who underwent transoral nonrobotic surgery for laryngo-pharyngeal squamous cell carcinoma between 2015 and 2021 in a multicenter retrospective study. Six hundred and forty patients were included. Postoperative bleeding was observed in 20 cases (3.1%), and the risk factor was advanced T category. Postoperative laryngeal edema was observed in 13 cases (2.0%), and the risk factors were prior radiotherapy, advanced T stage, and concurrent neck dissection in patients with resected HPC. Dysphagia requiring nutritional support was observed in 29 cases (4.5%) at 1 month postoperatively and in 19 cases (3.0%) at 1 year postoperatively, respectively. The risk factors for long-term dysphagia were prior radiotherapy and advanced T category. Short-term risk factors for dysphagia were prior radiotherapy, advanced T category, and concurrent neck dissection, while long-term risk factors for dysphagia were only prior radiotherapy and advanced T category. Prior radiotherapy, advanced T stage, and concurrent neck dissection increased the incidence of postoperative laryngeal edema and short-term dysphagia, but concurrent neck dissection did not affect long-term dysphagia. Such features should be considered when considering the indication for transoral surgery and postoperative management.

中文翻译：

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咽喉鳞状细胞癌经口非机器人手术后吞咽困难等并发症：一项回顾性多中心研究

经口手术是一种微创治疗，但引起严重吞咽困难的几率低于放化疗。我们在一项多中心回顾性研究中比较了 2015 年至 2021 年间接受经口非机器人手术治疗喉咽鳞状细胞癌的患者的临床信息、手术并发症和吞咽功能。其中包括六百四十名患者。术后出血20例（3.1%），危险因素为晚期T分类。术后出现喉头水肿13例（2.0%），危险因素为既往放疗、T分期晚、HPC切除患者并发颈清扫术。术后1个月和术后1年分别有29例（4.5%）和19例（3.0%）出现需要营养支持的吞咽困难。长期吞咽困难的危险因素是既往放疗和晚期T分类。吞咽困难的短期危险因素是既往放疗、晚期T分类和同期颈清扫术，而吞咽困难的长期危险因素仅为既往放疗和晚期T分类。既往放疗、T分期晚期、并发颈清扫术增加术后喉水肿和短期吞咽困难的发生率，但并发颈清扫术并不影响长期吞咽困难。在考虑经口手术和术后处理的指征时，应考虑这些特征。