Martínez Vidal J, López Amado M, Herranz González-Botas J, Vázquez Barro C, García Sarandeses A
Departamento de ORL, Hospital Juan Canalejo, La Coruña.
Acta Otorrinolaringol Esp. 1997 May;48(4):291-4.
The relationship between emergency tracheotomy (ET) and stomal recurrence (SR) was evaluated in 369 patients who underwent surgery for laryngeal cancer. Emergency tracheostomy was performed in 31 patients. Age, sex, primary location, T stage, pN stage, histological grading, and time from emergency tracheotomy to definitive treatment were examined. Stomal recurrence occurred in 2.1% overall; in 1.2% of the tracheotomy-free group, and in 13% (4/31) of the emergency tracheotomy group (p < 0.0001). Recurrences were significantly more frequent in subglottic (p = 0.00007) and T3 lesions (p < 0.0001). Emergency tracheostomy often is needed in patients who have primary subglottic tumors or tumors than invade the subglottis. The relationship between ET and SR appears to be more circumstantial than causal. Aggressive local treatment is recommended in patients with subglottic lesions or subglottic tumor extension to prevent SR.
对369例行喉癌手术的患者评估了紧急气管切开术（ET）与造口复发（SR）之间的关系。31例患者进行了紧急气管切开术。研究了年龄、性别、原发部位、T分期、pN分期、组织学分级以及从紧急气管切开术到确定性治疗的时间。总体造口复发率为2.1%；未行气管切开术的患者中复发率为1.2%，紧急气管切开术组的复发率为13%（4/31）（p<0.0001）。声门下（p=0.00007）和T3病变（p<0.0001）的复发明显更频繁。原发性声门下肿瘤或侵犯声门下的肿瘤患者通常需要紧急气管切开术。ET与SR之间的关系似乎更多是间接的而非因果关系。对于有声门下病变或声门下肿瘤扩展的患者，建议采取积极的局部治疗以预防SR。
