Zaker Amirreza, Peyvandi Aliasghar, Fazli Mohsen, Bazgir Narges, Vakili Kimia, Fathi Mobin, Mokhtarinejad Farhad, Rahmani Zahra, Gachkar Latif, Khajavi Mahdi
Hearing Disorder Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, Shahid Beheshti University of Medical sciences, Tehran, Iran.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4096-4101. doi: 10.1007/s12070-024-04790-w. Epub 2024 Jul 23.
Laryngeal cancer is a common advanced head and neck cancer. Surgery, radiation, chemotherapy, or a combination of these treatments are used to treat locally advanced laryngeal cancer. Total laryngectomy is generally preferred for T3-4 laryngeal cancers, despite being an invasive procedure. Post-surgical hypocalcemia is a known complication of neck compartment surgeries, and patients who have undergone laryngectomy are at a higher risk of developing hypoparathyroidism, leading to hypocalcemia. This study aims to investigate the prevalence and risk factors of hypocalcemia in individuals following laryngectomy.
This retrospective study examined 50 consecutive laryngectomy patients over eight years. Data on demographic characteristics, medical history, surgical details, pre-and post-operative calcium levels, neck dissection laterality, history of radiotherapy were collected. Hypocalcemia was defined as calcium levels < 8.5 mg/dl or corrected calcium < 8.5 mg/dl. Statistical analyses included paired t-tests, Wilcoxon signed-rank tests, and binary logistic regression using R studio.
The mean age of participants was 59 years, predominating males (94%) and habitual smokers (94%). Squamous cell carcinoma was the most prevalent (98%) pathological diagnosis, and various surgical techniques were employed. While initial comparisons showed no significant changes in calcium levels pre-and post-operatively, adjusting for albumin levels revealed a significant association. Logistic regression identified neck dissection, low pre-operative calcium, radiotherapy, and total thyroidectomy as significant predictors of post-operative hypocalcemia ( < 0.05).
Surgical factors such as neck dissection and total thyroidectomy, alongside albumin levels, significantly impact postoperative hypocalcemia. These findings underscore the need for meticulous monitoring and potential preventive measures to manage calcium imbalance post-laryngectomy.
喉癌是一种常见的晚期头颈癌。手术、放疗、化疗或这些治疗方法的联合应用用于治疗局部晚期喉癌。尽管全喉切除术是一种侵入性手术，但对于T3 - 4期喉癌通常更倾向于采用该手术。术后低钙血症是颈部间隙手术已知的并发症，接受喉切除术的患者发生甲状旁腺功能减退从而导致低钙血症的风险更高。本研究旨在调查喉切除术后患者低钙血症的患病率及危险因素。
这项回顾性研究对八年间连续的50例喉切除患者进行了检查。收集了有关人口统计学特征、病史、手术细节、术前和术后钙水平、颈部清扫侧别、放疗史的数据。低钙血症定义为血钙水平＜8.5mg/dl或校正血钙＜8.5mg/dl。统计分析包括配对t检验、Wilcoxon符号秩检验以及使用R studio进行的二元逻辑回归分析。
参与者的平均年龄为59岁，以男性（94%）和习惯性吸烟者（94%）为主。鳞状细胞癌是最常见的（98%）病理诊断，采用了多种手术技术。虽然最初的比较显示术前和术后钙水平无显著变化，但调整白蛋白水平后发现存在显著关联。逻辑回归分析确定颈部清扫、术前低钙、放疗和全甲状腺切除术是术后低钙血症的显著预测因素（P＜0.05）。
颈部清扫和全甲状腺切除术等手术因素以及白蛋白水平对术后低钙血症有显著影响。这些发现强调了在喉切除术后对钙失衡进行细致监测和采取潜在预防措施的必要性。
