Yotakis J, Davris S, Kontozoglou T, Adamopoulos G
ENT Clinic, University of Athens, Greece.
Clin Otolaryngol Allied Sci. 1996 Apr;21(2):135-8. doi: 10.1111/j.1365-2273.1996.tb01317.x.
The development of a stomal recurrence after total laryngectomy is a complication with a dismal prognosis. The risk factors and mechanisms involved are still not well understood. In this review of 352 patients, 21 (6%) developed a stomal recurrence. We studied the group of 74 patients (21%) with subglottic involvement separately. There was no significant difference in the rate of stomal recurrence in those with emergency tracheostomy (23.3%) as compared with those with intra-operative tracheostomy (18.2%). Stomal recurrence was more strongly associated with subglottic involvement itself (20.3%) and T4 stage (15.3%). The findings suggest that submucosal extension and lymph node metastases are probably more important mechanisms of stomal recurrence than cancer cell implantation.
全喉切除术后造口复发是一种预后不佳的并发症。其相关的危险因素和机制仍未完全明确。在这项对352例患者的回顾性研究中，21例（6%）出现了造口复发。我们单独研究了74例（21%）有声门下受累的患者。急诊气管切开患者的造口复发率（23.3%）与术中气管切开患者（18.2%）相比，无显著差异。造口复发与声门下受累本身（20.3%）和T4期（15.3%）的相关性更强。研究结果表明，黏膜下扩展和淋巴结转移可能是比癌细胞种植更重要的造口复发机制。
