Systematic review and meta-analysis of the complications of salvage total laryngectomy

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• 作者：Z. Hasan^a ; ^{zubairhasan_112@hotmail.com} ; R.C. Dwivedi^b ; D.A. Gunaratne^a ; S.A. Virk^c ; C.E. Palme^a ; F. Riffat^a
• 关键词：Laryngeal cancer ; Laryngectomy ; Salvage surgery ; Pharyngocutaneous fistula ; Complications ; Head & neck surgery
• 刊名：European Journal of Surgical Oncology (EJSO)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：43
• 期：1
• 页码：42-51
• 全文大小：833 K
• 卷排序：43

文摘

Management paradigms in laryngeal cancer have shifted to “organ preservation” chemoradiotherapy protocols. In the event of treatment failure, salvage total laryngectomy remains the only curative treatment option. However a comprehensive review of the complications of this procedure has not been reported.MethodsA systematic review of the literature was performed using keywords “salvage laryngectomy” to retrieve relevant publications between January 2000 and August 2015.ResultsOf the 407 articles retrieved from the literature search, 50 studies encompassing 3292 patients were included. Forty-nine studies reported pharyngocutaneous fistula which occurred in 859 patients (pooled incidence 28.9%; 95% confidence intervals 25.5–32.5%). Twenty-four studies reported complications in addition to PCF and these included wound complications (infection, dehiscence and necrosis), dysphagia, bleeding, and pharyngeal and stomal stenosis.ConclusionsOverall complication rate was 67.5%, Pharyngocutaneous fistula was the commonest complication with a pooled incidence of 28.9%.