Xiao Christopher C, Imam Sarah A, Nguyen Shaun A, Camilon Marc P, Baker Andrew B, Day Terry A, Lentsch Eric J
Department of Otolaryngology- Head and Neck Surgery, Kaiser Permanente, Northern California, Oakland, CA, 94612, USA.
Department of Health and Human Performance, The Citadel, Charleston, SC, 29409, USA.
World J Otorhinolaryngol Head Neck Surg. 2019 Dec 5;5(4):215-221. doi: 10.1016/j.wjorl.2019.01.004. eCollection 2019 Dec.
To examine the national rates of complications, readmission, reoperation, death and length of hospital stay after laryngectomy. To explore the risks of neck dissection with laryngectomy using outcomes.
The American College of Surgeons National Quality Improvement Program (ACS-NSQIP) database was reviewed retrospectively. The database was analyzed for patients undergoing laryngectomy with and without neck dissection. Demographic, perioperative complication, reoperation, readmission, and death variables were analyzed.
754 patients who underwent total laryngectomy during this time were found. Demographic analysis showed average age was 63 years old, 566 (75.1%) were white, and 598 (79.3%) were male. Of these patients, 520 (69.0%) included a neck dissection while 234 (31.0%) did not. When comparing patients who received a neck dissection to those who did not, there were no significant differences in median length of hospital stay (12.5 days w/ 13.3 days w/o, = 0.99), rates of complication (40% w/ 35% w/o, = 0.23), reoperation (13.5% w/ 14% w/o, = 0.81), readmission (14% w/ 18% w/o, = 0.27), and death (1.3% w/ 1.3% w/o, > 0.99). Furthermore, neck dissection did not increase the risk of complication ( = 0.23), readmission ( = 0.27), reoperation ( = 0.81), death ( = 0.94), or lengthened hospital stay ( = 0.38).
Concurrent neck dissection does not increase postoperative morbidity or mortality in patients undergoing total laryngectomies. These results may help physicians make decisions regarding concurrent neck dissection with total laryngectomy.
研究喉切除术后并发症、再入院、再次手术、死亡的全国发生率以及住院时间。利用相关结果探讨喉切除联合颈部清扫术的风险。
回顾性分析美国外科医师学会国家质量改进计划（ACS-NSQIP）数据库。对接受或未接受颈部清扫术的喉切除术患者的数据库进行分析。分析人口统计学、围手术期并发症、再次手术、再入院和死亡变量。
在此期间共发现754例行全喉切除术的患者。人口统计学分析显示，平均年龄为63岁，566例（75.1%）为白人，598例（79.3%）为男性。其中，520例（69.0%）接受了颈部清扫术，234例（31.0%）未接受。将接受颈部清扫术的患者与未接受颈部清扫术的患者进行比较，住院中位时间（接受清扫术者为12.5天，未接受者为13.3天，P = 0.99）、并发症发生率（接受清扫术者为40%，未接受者为35%，P = 0.23）、再次手术率（接受清扫术者为13.5%，未接受者为14%，P = 0.81）、再入院率（接受清扫术者为14%，未接受者为18%，P = 0.27）和死亡率（接受清扫术者为1.3%，未接受者为1.3%，P>0.99）均无显著差异。此外，颈部清扫术并未增加并发症风险（P = 0.23）、再入院风险（P = 0.27）、再次手术风险（P = 0.81）、死亡风险（P = 0.94）或延长住院时间（P = 0.38）。
同期颈部清扫术不会增加全喉切除术患者的术后发病率或死亡率。这些结果可能有助于医生在全喉切除术时就同期颈部清扫术做出决策。
