Fiorini Francesca Romana, Deganello Alberto, Larotonda Guglielmo, Mannelli Giuditta, Gallo Oreste
Academic Clinic of Otolaryngology-Head and Neck Surgery, University of Florence, Via Largo Brambilla 3, 50134 Florence, Italy.
Cancers (Basel). 2014 Aug 19;6(3):1727-35. doi: 10.3390/cancers6031727.
Smoking is an important risk factor in the development of head and neck cancer. However, little is known about its effects on postoperative complications in head and neck cancer surgery. We performed a retrospective analysis on 535 consecutive laryngeal cancer patients submitted to open partial laryngectomy at the Otolaryngology-Head and Neck Surgery Department of Florence University to evaluate a possible correlation between smoking and surgical complications. Patients were grouped in non smokers and smokers and evaluated for airway, swallowing, local and fistula complications by multivariate analysis: 507 (95%) patients were smokers, 69% presented supraglottic, 30% glottic and 1% transglottic cancer. The most common operation was supraglottic horizontal laryngectomy in 58%, followed by supracricoid partial laryngectomy in 27% and frontolateral hemilaryngectomy in 15% of cases. The incidence of overall complications was 30%, airway complications representing the most frequent (14%), followed by swallowing (7%), local (6%) and fistula complications (3%). Smokers developed more local complications (p = 0.05, univariate, p = 0.04, multivariate analysis) and pharyngocutaneous fistula (p = 0.01, univariate, p = 0.03, multivariate analysis).
吸烟是头颈癌发生的一个重要风险因素。然而，关于其对头颈癌手术术后并发症的影响却知之甚少。我们对佛罗伦萨大学耳鼻咽喉 - 头颈外科连续535例行开放性部分喉切除术的喉癌患者进行了回顾性分析，以评估吸烟与手术并发症之间可能存在的相关性。患者被分为非吸烟者和吸烟者，并通过多变量分析评估气道、吞咽、局部和瘘管并发症：507名（95%）患者为吸烟者，69%患有声门上癌，30%患有声门癌，1%患有跨声门癌。最常见的手术是声门上水平喉切除术，占58%，其次是环状软骨上部分喉切除术，占27%，前外侧半喉切除术占15%。总体并发症发生率为30%，气道并发症最为常见（14%），其次是吞咽并发症（7%）、局部并发症（6%）和瘘管并发症（3%）。吸烟者出现更多的局部并发症（单变量分析p = 0.05，多变量分析p = 0.04）和咽皮肤瘘（单变量分析p = 0.01，多变量分析p = 0.03）。
