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本文引用的文献

1
Enlarged tracheoesophageal puncture after total laryngectomy: a systematic review and meta-analysis.全喉切除术后气管食管瘘的扩大：系统评价和荟萃分析。
Head Neck. 2011 Jan;33(1):20-30. doi: 10.1002/hed.21399.
2
Complications that affect postlaryngectomy voice restoration: primary surgery vs salvage surgery.影响喉切除术后嗓音恢复的并发症：初次手术与挽救性手术
Arch Otolaryngol Head Neck Surg. 2009 Nov;135(11):1165-9. doi: 10.1001/archoto.2009.168.
3
Cigarette smoking among adults and trends in smoking cessation - United States, 2008.2008年美国成年人吸烟情况及戒烟趋势
MMWR Morb Mortal Wkly Rep. 2009 Nov 13;58(44):1227-32.
4
Results of vocal rehabilitation using tracheoesophageal voice prosthesis after total laryngectomy and their predictive factors.全喉切除术后使用气管食管语音假体进行嗓音康复的结果及其预测因素。
Eur Arch Otorhinolaryngol. 2010 May;267(5):751-8. doi: 10.1007/s00405-009-1138-x. Epub 2009 Nov 5.
5
Primary versus secondary tracheoesophageal puncture in salvage total laryngectomy following chemoradiation.同步放化疗后挽救性全喉切除术中一期与二期气管食管穿刺的比较
Otolaryngol Head Neck Surg. 2009 Mar;140(3):386-90. doi: 10.1016/j.otohns.2008.10.018.
6
Investigation of tracheoesophageal voice prosthesis leakage patterns: patient's self-report versus clinician's confirmation.气管食管发音假体泄漏模式的研究：患者自我报告与临床医生确认
Head Neck. 2008 May;30(5):618-21. doi: 10.1002/hed.20764.
7
Cellular and molecular mechanisms of fibrosis.纤维化的细胞和分子机制。
J Pathol. 2008 Jan;214(2):199-210. doi: 10.1002/path.2277.
8
Submucosal purse-string suture as a treatment of leakage around the indwelling voice prosthesis.黏膜下荷包缝合术治疗带蒂发音假体周围渗漏
Head Neck. 2008 Apr;30(4):485-91. doi: 10.1002/hed.20732.
9
[The custom-fit voice prosthesis, for treatment of periprothetic leakage after tracheoesophageal voice restoration].[定制适配的语音假体，用于气管食管语音恢复后假体周围渗漏的治疗]
Laryngorhinootologie. 2006 Jul;85(7):496-500. doi: 10.1055/s-2006-925081. Epub 2006 Feb 21.
10
Proximal esophageal contractions in laryngectomized patients.喉切除患者的近端食管收缩
Dysphagia. 2005 Spring;20(2):101-4. doi: 10.1007/s00455-004-0027-0.

全喉切除术后气管食管造瘘口扩大的多因素分析。

Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy.

机构信息

Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

出版信息

Head Neck. 2012 Apr;34(4):557-67. doi: 10.1002/hed.21777. Epub 2011 Jun 20.

DOI:10.1002/hed.21777
PMID:21692129
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4012756/
Abstract

BACKGROUND

Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high-risk individuals, and surgical and prosthetic correlates of TEP enlargement.

METHODS

Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5-year retrospective cohort.

RESULTS

Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow-up and timing of TEP, advanced (N2 or N3) nodal disease (odds ratio OR , 4.3; 95% confidence interval [CI], 1.0-19.1), postoperative stricture (OR(adjusted) , 3.2; 95% CI, 1.2-8.6), and diagnosis of locoregional recurrence or distant metastasis after laryngectomy (OR(adjusted) , 6.2; 95% CI, 2.3-16.4) increased risk of enlarged TEP. Extended resection and preoperative nutritional status were also significantly associated with enlarged TEP. Prosthetic parameters did not significantly correlate with enlargement.

CONCLUSION

Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors.

摘要

背景

扩大的气管食管造口术（TEP）是手术假体语音修复的一种具有挑战性的并发症。预防这种并发症需要确定高危人群，以及 TEP 扩大的手术和假体相关性。

方法

多变量逻辑回归方法用于分析 5 年回顾性队列中扩大 TEP 的术前、围手术期和术后危险因素。

结果

仅在接受放疗的患者中发生扩大的 TEP。调整随访时间和 TEP 时间后，晚期（N2 或 N3）淋巴结疾病（优势比[OR]（调整），4.3；95%置信区间[CI]，1.0-19.1）、术后狭窄（OR（调整），3.2；95%CI，1.2-8.6）和喉切除术后局部区域复发或远处转移的诊断（OR（调整），6.2；95%CI，2.3-16.4）增加了 TEP 扩大的风险。广泛切除和术前营养状况也与 TEP 扩大显著相关。假体参数与扩大无显著相关性。

结论

TEP 的扩大是一个与基线和术后因素相关的多因素过程。