Complications and Pre-disposing Factors from a Decade of Total Laryngectomy

Chris Thompson, Panagiotis Asimakopoulos, Andy Evans, Guy A. Vernham, Alasdair Hay, Iain Nixon

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction
Total Laryngectomy is often utilised to manage Squamous Cell Carcinoma of the larynx/hypopharynx. We report surgical trends and outcomes over a 10-year period.
Methods
A retrospective review of patients undergoing total laryngectomy for squamous cell carcinoma was performed (n=173), dividing patients into Primary (PTL) and Salvage (STL) cohorts.
Results
A shift towards organ-sparing management was observed. PTL was performed for locoregionally advanced disease and utilised reconstruction less than STL.

Overall, 11% of patients developed pharyngo-cutaneous fistula (6%/20% in PTL/STL) and 11% neo-pharyngeal stenosis (9%/15% in PTL/STL). pharyngo-cutaneous fistula rates were higher in the reconstructed PTL group (24%, 4/17), compared with primary closure (3%, 3/90), (p=0.02). Patients were significantly more likely to develop neo-pharyngeal stenosis following pharyngo-cutaneous fistula in STL (p=0.01) and reconstruction in PTL (p=0.02). Pre-operative haemaglobin and adjuvant treatment failed to predict pharyngo-cutaneous fistula development.
Conclusions
Complications remain hard to predict and are continuing causes of morbidity. Additionally, prior treatment continues to have an effect on surgical outcomes.
Original languageEnglish
JournalJournal of Laryngology and Otology
Volume134
Issue number3
Early online date21 Feb 2020
DOIs
Publication statusPublished - Mar 2020

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