Ganly Ian, Patel Snehal G, Matsuo Jeanette, Singh Bhuvanesh, Kraus Dennis H, Boyle Jay, Wong Richard, Shaha Ashok R, Shah Jatin P
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Head Neck. 2009 Mar;31(3):338-45. doi: 10.1002/hed.20975.
The objective of this study was to report the incidence of postoperative complications for partial laryngectomy and to identify patient- and tumor-related factors predictive of postoperative complications.
A total of 150 patients who had a partial laryngectomy were identified from an existing database of 662 patients treated for squamous cell carcinoma of the larynx from 1984 to 1998. Postoperative complications were recorded and categorized into local, swallowing, airway, and systemic complications. Patient- and tumor-related predictors of complications were identified by univariate and multivariate analyses.
There was no postoperative mortality. Twenty percent of patients developed a postoperative complication following partial laryngectomy. Local complications were the most frequent complication and occurred in 17 (11%) patients. Laryngocutaneous fistula occurred in 6 (4%) patients. Multivariate analysis showed that prior radiation was an independent predictor of local complications and laryngocutaneous fistula with a 13-fold increase in relative risk for both.
Partial laryngectomy following radiotherapy was more frequently associated with postoperative complications. Problems related to local wound healing, especially the development of laryngocutaneous fistula, constituted the most common postoperative complication in these patients.
本研究的目的是报告部分喉切除术的术后并发症发生率,并确定预测术后并发症的患者相关因素和肿瘤相关因素。
从1984年至1998年接受喉鳞状细胞癌治疗的662例患者的现有数据库中,确定了150例行部分喉切除术的患者。记录术后并发症并分为局部、吞咽、气道和全身并发症。通过单因素和多因素分析确定并发症的患者相关预测因素和肿瘤相关预测因素。
无术后死亡病例。20%的患者在部分喉切除术后出现术后并发症。局部并发症是最常见的并发症,17例(11%)患者发生。6例(4%)患者发生喉皮瘘。多因素分析显示,既往放疗是局部并发症和喉皮瘘的独立预测因素,两者的相对风险均增加13倍。
放疗后行部分喉切除术更常与术后并发症相关。与局部伤口愈合相关的问题,尤其是喉皮瘘的发生,是这些患者最常见的术后并发症。