Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy
Identifieur interne : 000172 ( Istex/Corpus ); précédent : 000171; suivant : 000173Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy
Auteurs : Katherine A. Hutcheson ; Jan S. Lewin ; Erich M. Sturgis ; Jan RisserSource :
- Head & Neck [ 1043-3074 ] ; 2012-04.
Abstract
Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high‐risk individuals, and surgical and prosthetic correlates of TEP enlargement.
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DOI: 10.1002/hed.21777
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ISTEX:0390BCBD18CC57BB3DCDA935E0FA3537BDF1FBEELe document en format XML
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Prevention of this complication requires identification of high‐risk individuals, and surgical and prosthetic correlates of TEP enlargement.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>laryngectomy</json:string><json:string>postoperative</json:string><json:string>prosthesis</json:string><json:string>puncture</json:string><json:string>prosthetic</json:string><json:string>risk factors</json:string><json:string>stricture</json:string><json:string>multivariable</json:string><json:string>preoperative</json:string><json:string>radiotherapy</json:string><json:string>referent</json:string><json:string>tracheoesophageal</json:string><json:string>univariable</json:string><json:string>locoregional</json:string><json:string>total laryngectomy</json:string><json:string>locoregional recurrence</json:string><json:string>postoperative stricture</json:string><json:string>nodal</json:string><json:string>recurrence</json:string><json:string>voice prosthesis</json:string><json:string>teps</json:string><json:string>april</json:string><json:string>regression model</json:string><json:string>laryngopharyngectomy</json:string><json:string>distant metastasis</json:string><json:string>metastasis</json:string><json:string>cohort</json:string><json:string>tracheoesophageal puncture</json:string><json:string>univariable analyses</json:string><json:string>resection</json:string><json:string>head april</json:string><json:string>otolaryngol</json:string><json:string>leakage</json:string><json:string>multivariable model</json:string><json:string>surg</json:string><json:string>hypopharyngeal</json:string><json:string>total laryngopharyngectomy</json:string><json:string>anderson cancer center</json:string><json:string>perioperative</json:string><json:string>chemotherapy</json:string><json:string>nodal disease</json:string><json:string>recurrent cancer</json:string><json:string>insertion</json:string><json:string>disease characteristics</json:string><json:string>regression methods</json:string><json:string>prosthetic variables</json:string><json:string>head neck</json:string><json:string>weight loss</json:string><json:string>postoperative risk factors</json:string><json:string>primary risk factors</json:string><json:string>surgical</json:string><json:string>treatment variables</json:string><json:string>potential risk factors</json:string><json:string>prosthetic factors</json:string><json:string>relative risk</json:string><json:string>odds ratio</json:string><json:string>marital status</json:string><json:string>study period</json:string><json:string>postoperative month</json:string><json:string>largest diameter</json:string><json:string>surgical variables</json:string><json:string>prosthetic insertion</json:string><json:string>hypopharyngeal disease</json:string><json:string>disease control</json:string><json:string>regression models</json:string></teeft></keywords><author><json:item><name>Katherine A. Hutcheson PhD</name><affiliations><json:string>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</json:string><json:string>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</json:string></affiliations></json:item><json:item><name>Jan S. Lewin PhD</name><affiliations><json:string>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</json:string></affiliations></json:item><json:item><name>Erich M. Sturgis MD, MPH</name><affiliations><json:string>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</json:string><json:string>Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</json:string></affiliations></json:item><json:item><name>Jan Risser PhD</name><affiliations><json:string>Division of Epidemiology and Disease Control, The University of Texas School of Public Health, Houston, Texas</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>tracheoesophageal puncture</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>total laryngectomy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>enlarged tracheoesophageal puncture</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>risk 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A.</forename><surname>Hutcheson</surname><roleName type="degree">PhD</roleName></persName><email>karnold@mdanderson.org</email><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas<address><country key="US"></country></address></affiliation><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Jan S.</forename><surname>Lewin</surname><roleName type="degree">PhD</roleName></persName><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas<address><country key="US"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Erich M.</forename><surname>Sturgis</surname><roleName type="degree">MD, MPH</roleName></persName><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas<address><country key="US"></country></address></affiliation><affiliation>Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas<address><country key="US"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Jan</forename><surname>Risser</surname><roleName type="degree">PhD</roleName></persName><affiliation>Division of Epidemiology and Disease Control, The University of Texas School of Public Health, Houston, Texas<address><country key="US"></country></address></affiliation></author><idno type="istex">0390BCBD18CC57BB3DCDA935E0FA3537BDF1FBEE</idno><idno type="DOI">10.1002/hed.21777</idno><idno type="unit">HED21777</idno><idno type="toTypesetVersion">file:HED.HED21777.pdf</idno></analytic><monogr><title level="j" type="main">Head & Neck</title><title level="j" type="alt">HEAD AND NECK</title><idno type="pISSN">1043-3074</idno><idno type="eISSN">1097-0347</idno><idno type="book-DOI">10.1002/(ISSN)1097-0347</idno><idno type="book-part-DOI">10.1002/hed.v34.4</idno><idno type="product">HED</idno><imprint><biblScope unit="vol">34</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="557">557</biblScope><biblScope unit="page" to="567">567</biblScope><biblScope unit="page-count">11</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2012-04"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Background
<p>Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high‐risk individuals, and surgical and prosthetic correlates of TEP enlargement.</p>
Methods
<p>Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5‐year retrospective cohort.</p>
Results
<p>Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow‐up and timing of TEP, advanced (N2 or N3) nodal disease (odds ratio [OR]<hi rend="subscript">adjusted</hi>, 4.3; 95% confidence interval [CI], 1.0–19.1), postoperative stricture (OR<hi rend="subscript">adjusted</hi>, 3.2; 95% CI, 1.2–8.6), and diagnosis of locoregional recurrence or distant metastasis after laryngectomy (OR<hi rend="subscript">adjusted</hi>, 6.2; 95% CI, 2.3–16.4) increased risk of enlarged TEP. Extended resection and preoperative nutritional status were also significantly associated with enlarged TEP. Prosthetic parameters did not significantly correlate with enlargement.</p>
Conclusion
<p>Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors. © 2011 Wiley Periodicals, Inc. Head Neck, 2012</p></abstract><textClass><keywords xml:lang="en"><term xml:id="kwd1">tracheoesophageal puncture</term><term xml:id="kwd2">total laryngectomy</term><term xml:id="kwd3">enlarged tracheoesophageal puncture</term><term xml:id="kwd4">risk factors</term></keywords><classCode scheme="articleCategory">Original Article</classCode><classCode scheme="tocHeading1">Original Articles</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/0390BCBD18CC57BB3DCDA935E0FA3537BDF1FBEE/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta 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value="HED21777"></id></idGroup><countGroup><count type="pageTotal" number="11"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2011 Wiley Periodicals, Inc.</copyright><eventGroup><event type="manuscriptAccepted" date="2011-02-15"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:3.1.3 standalone mode:FullText" date="2012-03-03"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-06-20"></event><event type="firstOnline" date="2011-06-20"></event><event type="publishedOnlineFinalForm" date="2012-03-03"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-27"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.3.4 mode:FullText" date="2015-02-24"></event></eventGroup><numberingGroup><numbering 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A.</givenNames><familyName>Hutcheson</familyName><degrees>PhD</degrees></personName><contactDetails><email>karnold@mdanderson.org</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Jan S.</givenNames><familyName>Lewin</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Erich M.</givenNames><familyName>Sturgis</familyName><degrees>MD, MPH</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Jan</givenNames><familyName>Risser</familyName><degrees>PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Division of Epidemiology and Disease Control, The University of Texas School of Public Health, Houston, Texas</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">tracheoesophageal puncture</keyword><keyword xml:id="kwd2">total laryngectomy</keyword><keyword xml:id="kwd3">enlarged tracheoesophageal puncture</keyword><keyword xml:id="kwd4">risk factors</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background</title><p>Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high‐risk individuals, and surgical and prosthetic correlates of TEP enlargement.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5‐year retrospective cohort.</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow‐up and timing of TEP, advanced (N2 or N3) nodal disease (odds ratio [OR]<sub>adjusted</sub>, 4.3; 95% confidence interval [CI], 1.0–19.1), postoperative stricture (OR<sub>adjusted</sub>, 3.2; 95% CI, 1.2–8.6), and diagnosis of locoregional recurrence or distant metastasis after laryngectomy (OR<sub>adjusted</sub>, 6.2; 95% CI, 2.3–16.4) increased risk of enlarged TEP. Extended resection and preoperative nutritional status were also significantly associated with enlarged TEP. Prosthetic parameters did not significantly correlate with enlargement.</p></section><section xml:id="abs1-4"><title type="main">Conclusion</title><p>Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors. © 2011 Wiley Periodicals, Inc. Head Neck, 2012</p></section></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Risk Factors for Enlarged TEP</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy</title></titleInfo><name type="personal"><namePart type="given">Katherine A.</namePart><namePart type="family">Hutcheson</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jan S.</namePart><namePart type="family">Lewin</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Erich M.</namePart><namePart type="family">Sturgis</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation><affiliation>Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Jan</namePart><namePart type="family">Risser</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Division of Epidemiology and Disease Control, The University of Texas School of Public Health, Houston, Texas</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2012-04</dateIssued><dateValid encoding="w3cdtf">2011-02-15</dateValid><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">30</extent><extent unit="words">10325</extent></physicalDescription><abstract>Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high‐risk individuals, and surgical and prosthetic correlates of TEP enlargement.</abstract><abstract>Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5‐year retrospective cohort.</abstract><abstract>Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow‐up and timing of TEP, advanced (N2 or N3) nodal disease (odds ratio [OR]adjusted, 4.3; 95% confidence interval [CI], 1.0–19.1), postoperative stricture (ORadjusted, 3.2; 95% CI, 1.2–8.6), and diagnosis of locoregional recurrence or distant metastasis after laryngectomy (ORadjusted, 6.2; 95% CI, 2.3–16.4) increased risk of enlarged TEP. Extended resection and preoperative nutritional status were also significantly associated with enlarged TEP. Prosthetic parameters did not significantly correlate with enlargement.</abstract><abstract>Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors. © 2011 Wiley Periodicals, Inc. Head Neck, 2012</abstract><subject lang="en"><genre>keywords</genre><topic>tracheoesophageal puncture</topic><topic>total laryngectomy</topic><topic>enlarged tracheoesophageal puncture</topic><topic>risk factors</topic></subject><relatedItem type="host"><titleInfo><title>Head & Neck</title></titleInfo><titleInfo type="abbreviated"><title>Head Neck</title></titleInfo><genre type="journal">journal</genre><subject><genre>article-category</genre><topic>Original Article</topic></subject><identifier type="ISSN">1043-3074</identifier><identifier type="eISSN">1097-0347</identifier><identifier type="DOI">10.1002/(ISSN)1097-0347</identifier><identifier type="PublisherID">HED</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>34</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>557</start><end>567</end><total>11</total></extent></part></relatedItem><identifier type="istex">0390BCBD18CC57BB3DCDA935E0FA3537BDF1FBEE</identifier><identifier type="DOI">10.1002/hed.21777</identifier><identifier type="ArticleID">HED21777</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Wiley Periodicals, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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