Complications after total laryngectomy - Risk factors and perioperative approach to the patient

Authors

  • Sónia Martins Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de São João, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Helena Silveira Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de São João, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Mafalda Sousa Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de São João, Departamento de Cirurgia e Fisiologia da Faculdade de Medicina da Universidade do Porto, Portugal
  • Margarida Santos Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de São João, Porto Portugal
  • Ricardo P. Vaz Serviço de Otorrinolaringologia do Centro Hospitalar Universitário de São João, Unidade de Anatomia - Departamento de Biomedicina da Faculdade de Medicina da Universidade do Porto, Center for Health Technology and Services Research (CINTESIS), Porto, Portugal

DOI:

https://doi.org/10.34631/sporl.819

Keywords:

total laryngectomy, nutrition, pharyngocutaneous fistula.

Abstract

Objectives: To investigate the potential association between characteristics of patients submitted to total laryngectomy (TL) and postoperative complications. To outline perioperative strategies in order to prevent complications. 

Material and methods: Retrospective study that included 57 patients operated for larynx/pharynx epidermoid carcinoma between 2007 and 2019. Evaluated parameters included laryngectomized patient’s nutritional status, surgical factors, and neoplasm characteristics. 

Results: The overall postoperative complications rate was 43.8%: pharyngocutaneous fistula (19.3%), cervical abscess (17.5%) and seroma/hematoma (7%). The duration of hospital stays increased significantly (p<0.001) with postoperative complications and there was a significant association between higher leucocyte values and the development of complications (p=0.025). All patients presenting BMI< 20kg/m2 and albumin< 35g/L had pharyngocutaneous fistula. 

Conclusions: Post laryngectomy complications increase significantly the length of hospital stay. A multidisciplinary approach is crucial to reduce the rate of these situations. 

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Published

2020-12-05

How to Cite

Martins, S., Silveira, H., Sousa, M., Santos, M., & Vaz, R. P. (2020). Complications after total laryngectomy - Risk factors and perioperative approach to the patient. Portuguese Journal of Otorhinolaryngology and Head and Neck Surgery, 58(4), 173–179. https://doi.org/10.34631/sporl.819

Issue

Vol. 58 No. 4 (2020): December

Section

Original Article

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