[Complication of transoral robotic surgery: single institution study].

<b>Objective:</b> To investigate the complications of transoral robotic surgery (TORS) and to identify the risk factors for the complications. <b>Methods:</b> This was a retrospective study of 134 cases of head and neck tumors underwent TORS at the Department of Surgery of Beijing United Family Hospital from September 2017 to June 2024. There were 9 cases of benign tumors and 125 cases of malignant tumors, including 119 squamous cell carcinomas, 3 adenocarcinomas, 2 lymphomas, and 1 sarcoma. There were 37 cases of pure TORS and 96 cases of TORS combined with neck dissection. Postoperative complications within 90 days were collected and graded with the Clavien-Dindo system. <i>χ</i>² test was used for statistical analysis. <b>Results:</b> A total of 25 (18.7%) cases experienced surgical complications, including 9 cases with Clavien-Dindo grade≥Ⅲ complications. Postoperative complications included 2 cases of death, 3 cases of massive hemorrhage, 3 cases of pharyngeal fistula, 2 cases of aspiration pneumonia, 2 cases of minor bleeding, 1 case of tooth injury, 1 case of arytenoid dislocation, 2 cases of tongue laceration, and 10 cases of long-term (>3 months) tracheostomy open. Postoperative pharyngeal fistula was significantly correlated with the scope of neck dissection (<i>χ</i>²=9.86, <i>P</i><0.05), and Clavien-Dindo grade≥Ⅲ complications were significantly correlated with the scope of neck dissection (<i>χ</i>²=13.91, <i>P</i><0.05) and tumor N stage (<i>χ</i>²=14.33, <i>P</i><0.05). <b>Conclusion:</b> The high N-stage and neck dissection involving more than three regions are risk factors for the complications of TORS for head and neck tumors.