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TORS procedures were not associated with significant differences in acute postoperative morbidity or mortality. Multivariate generalized linear regression analyses of independent variables predictive of length of hospital stay and hospital-related costs are shown in Table 3, with mean values representing the change in the value of the intercept mean. Urgent or emergent admission, major surgical procedures, pedicled or free flap reconstruction, Medicare or Medicaid, payer status, comorbidity, black race, and surgery performed at a teaching hospital were significantly associated with greater length of hospitalization. Major surgical procedures, pedicled or free flap reconstruction, Medicaid payer status, comorbidity, and surgery performed at a teaching hospital were http://www.selleck.cn/products/carfilzomib-pr-171.html significantly associated with increased hospital costs, while age http://www.selleckchem.com/products/Metformin-hydrochloride(Glucophage).html decreased length of hospitalization (?1.5 days) and hospital-related costs (?$4,285). TORS offers a minimally invasive approach to tumors of the upper aerodigestive tract. In contrast to non-TORS surgical approaches in which pharyngotomy and mandibulotomy are frequently required for access, multiple institutional series have demonstrated TORS to have short hospital length of stays (LOS) http://www.selleckchem.com/products/BIBF1120.html and decreased morbidity and mortality.[17-21] Our analysis of nationwide inpatient data demonstrates that TORS is associated with a decreased length of hospital stay and hospital-related costs, and also is associated with a lower rate of gastrostomy tube and tracheotomy tube placement compared to other surgical techniques. Furthermore, we found that TORS is not associated with acute morbidity and mortality. It is noteworthy that the period covered in this study represents the earliest available data with TORS (2008�C2009), with most cases occurring in small, nonteaching hospitals when this technique was in its infancy. Thus, these data suggest that TORS may be a more generalizable surgical approach with a lower risk of immediate complications seen even in the early years of adoption into clinical practice concurrent with a learning curve. Critics of TORS have cited the expense of the da Vinci robot as unwarranted in today's heath care cost-containment environment. One should keep in mind that the robot is a capital investment made by the hospital, usually to support the urology, cardiac, and gynecology services as the surgical volume from otolaryngology would not justify the purchase.