Yuen A P, Wei W I, Ho W K, Hui Y
Department of Surgery, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Am J Surg. 1996 Sep;172(3):263-6. doi: 10.1016/S0002-9610(96)00162-6.
Tracheostomal recurrence after total laryngectomy for laryngeal carcinoma has a poor prognosis. The independent risk factors of tracheostomal recurrence are, however, not well documented.
This is a multivariate analysis of the risk factors of tracheostomal recurrence after total laryngectomy for 322 laryngeal squamous cell carcinomas. The factors included in the analysis were sex, age, tumor stage, sites of tumor involvement, preoperative airway obstruction, preoperative tracheostomy, extent of surgical resection, radiotherapy, and pathological resection margin.
Seventeen (5%) patients developed tracheostomal recurrence. Univariate analysis showed that preoperative airway obstruction, subglottic involvement, and postcricoid extension were significant factors associated with tracheostomal recurrence. Multivariate analysis using logistic regression method showed that both subglottic and postcricoid involvement were independent predisposing factors for tracheostomal recurrence. The tracheostomal recurrence rates were 2% in patients without the risk factor and 10% in patients with the presence of one or both risk factors.
Subglottic and postcricoid involvement were independent risk factors for tracheostomal recurrence.
喉癌全喉切除术后气管造口复发预后较差。然而，气管造口复发的独立危险因素尚无充分记录。
这是一项对322例喉鳞状细胞癌全喉切除术后气管造口复发危险因素的多因素分析。分析的因素包括性别、年龄、肿瘤分期、肿瘤累及部位、术前气道阻塞、术前气管造口、手术切除范围、放疗及病理切缘。
17例（5%）患者发生气管造口复发。单因素分析显示，术前气道阻塞、声门下受累及环状软骨后扩展是与气管造口复发相关的显著因素。采用逻辑回归方法进行的多因素分析显示，声门下及环状软骨后受累均是气管造口复发的独立易感因素。无危险因素患者的气管造口复发率为2%，存在一个或两个危险因素患者的复发率为10%。
声门下及环状软骨后受累是气管造口复发的独立危险因素。
