{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T06:08:10Z","timestamp":1788588490093,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T00:00:00Z","timestamp":1600992000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transcervical arterial ligation has been studied as a useful procedure to prevent bleeding events after transoral robotic surgery (TORS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review of English\u2010language literature on arterial ligation in TORS from 2005 to 2019 was conducted using Cochrane, PubMed, Web of Science (WoS), and ScienceDirect databases. Studies evaluating ligation and rates of postoperative hemorrhage were included. Meta\u2010analysis of included studies was performed to assess impact of ligation on postoperative hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five studies with 2008 patients were included. History of radiation (odds ratio [OR] = 2.26, <jats:italic>P<\/jats:italic> = .02) and advanced tumor stage (OR = 1.93, <jats:italic>P<\/jats:italic> = .02) were found to predispose patients to postoperative hemorrhage. Arterial ligation was protective against severe hemorrhage in the mixed primary surgical modality cohort (OR = 0.33, <jats:italic>P<\/jats:italic> = .03) and in the TORS\u2010only subgroup (OR = 0.21, <jats:italic>P<\/jats:italic> = .02), but did not significantly impact overall odds of postoperative hemorrhage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Transcervical arterial ligation offers protection against major\/severe postoperative hemorrhage in patients undergoing TORS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>II.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26480","type":"journal-article","created":{"date-parts":[[2020,9,25]],"date-time":"2020-09-25T08:10:11Z","timestamp":1601021411000},"page":"334-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Transcervical arterial ligation for prevention of <scp>postoperative<\/scp> hemorrhage in transoral oropharyngectomy: Systematic review and <scp>meta\u2010analysis<\/scp>"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5466-2630","authenticated-orcid":false,"given":"Daniel D.","family":"Sharbel","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Medical College of Georgia at Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Abkemeier","sequence":"additional","affiliation":[{"name":"Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Sullivan","sequence":"additional","affiliation":[{"name":"Medical College of Georgia Augusta University  Augusta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zach","family":"Zimmerman","sequence":"additional","affiliation":[{"name":"Department of 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