Early and long-term morbidity after total laryngopharyngectomy
September 2010
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To determine the early and long-term morbidity of patients treated with a total laryngopharyngectomy and reconstruction using a jejunum interposition or gastric pull-up procedure. It is a retrospective study; and it is conducted in tertiairy referral center. Sixty-three patients were included in whom 70 reconstructions were performed (51 jejunum interpositions and 19 gastric pull-up procedures) between 1990 and 2007. The studied parameters were success rate of the reconstruction, early and long-term complication rate, and functional outcome including quality of life. Subjective quality of life analysis was determined by two questionnaires: the EORTC Quality of Life Questionnaire (QLQ)-C30 Dutch version 3.0, and the EORTC-Head and Neck (H & N 35). The success rates were 84 and 74%, respectively. The procedures were associated with a high complication rate (63% after jejunum interposition and 89% after gastric pull-up), and a lengthy rehabilitation. Surviving patients were found to have a good long-term quality of life. Complete oral intake was achieved in 97%, and speech rehabilitation in 95%. These procedures are associated with significant morbidity, high complication rates, lengthy rehabilitation, but a good long-term quality of life.
- adult
- article
- female
- human
- male
- morbidity
- aged
- major clinical study
- priority journal
- controlled study
- overall survival
- mortality
- treatment outcome
- quality of life
- pneumonia
- sepsis
- cancer staging
- depression
- primary tumor
- retrospective study
- seizure
- graft failure
- peritonitis
- fistula
- wound dehiscence
- ileus
- tumor recurrence
- cholecystitis
- postoperative hemorrhage
- Functional results
- Gastric pull-up
- Horner syndrome
- Jejunum interposition
- Laryngopharyngectomy
- Reconstruction
- anastomosis dehiscence
- ear nose throat surgery
- hemiparesis
- hypopharyngectomy
- jejunum interposition
- mediastinitis
- operation
- pull through
- questionnaire; respiratory failure
- stomach spasm
- speech rehabilitation
- tertiary health care
- tracheitis