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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<front><div type="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.</div>
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<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>
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<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>
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<titleInfo type="abbreviated" lang="en"><title>Risk Factors for Enlarged TEP</title>
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<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy</title>
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<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>
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<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>
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<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>
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<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>
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<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>
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<identifier type="ISSN">1043-3074</identifier>
<identifier type="eISSN">1097-0347</identifier>
<identifier type="DOI">10.1002/(ISSN)1097-0347</identifier>
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<part><date>2012</date>
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