León X, Quer M, Burgués J, Abelló P, Vega M, de Andrés L
Department of Otolaryngology, Hospital de la Santa Creu i Sant Paul, Barcelona, Spain.
Head Neck. 1996 Jan-Feb;18(1):54-9. doi: 10.1002/(SICI)1097-0347(199601/02)18:1<54::AID-HED7>3.0.CO;2-Y.
The authors reviewed the incidence of stomal recurrence (SR) in a population of laryngectomized patients to study associated risk factors and determine the usefulness of certain preventive procedures.
A retrospective study was performed in 296 patients with larynx and hypopharynx carcinoma treated by total laryngectomy.
Of the 296 patients, 6 (2%) were initially seen with SR. In all cases, a risk factor was found to be involved: subglottic extension (5 cases), tracheotomy prior to laryngectomy (1 case). Since 1989, when preventive measures were systematically introduced in patients presenting risk factors, there have been no further cases of SR. The surgical measures in tumors with subglottic extension consisted of hemithyroidectomies, paratracheal lymph node dissection, and extensive tracheal resection; in the case of a tracheotomy prior to the laryngectomy, extensive resections of the tracheal stoma were carried out.
The systematic use of preventive surgical measures together with postoperative radiotherapy to the stoma and superior mediastinum have led to a decrease in the appearance of SR.
作者回顾了喉切除患者中吻合口复发（SR）的发生率，以研究相关危险因素并确定某些预防措施的有效性。
对296例行全喉切除术治疗的喉癌和下咽癌患者进行了一项回顾性研究。
在296例患者中，6例（2%）最初被发现有吻合口复发。所有病例均发现有一个危险因素：声门下扩展（5例），喉切除术前气管切开（1例）。自1989年以来，当对有危险因素的患者系统地采取预防措施后，未再出现吻合口复发病例。对于有声门下扩展的肿瘤，手术措施包括甲状腺半切除术、气管旁淋巴结清扫和广泛的气管切除；对于喉切除术前气管切开的病例，对气管造口进行了广泛切除。
系统地使用预防性手术措施以及对造口和上纵隔进行术后放疗，已使吻合口复发的发生率降低。
