Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy
Identifieur interne : 004750 ( Main/Merge ); précédent : 004749; suivant : 004751Multivariable analysis of risk factors for enlargement of the tracheoesophageal puncture after total laryngectomy
Auteurs : Katherine A. Hutcheson [États-Unis] ; Jan S. Lewin [États-Unis] ; Erich M. Sturgis [États-Unis] ; Jan Risser [États-Unis]Source :
- 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.
Url:
- https://api.istex.fr/document/0390BCBD18CC57BB3DCDA935E0FA3537BDF1FBEE/fulltext/pdf
- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4012756
DOI: 10.1002/hed.21777
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Enlarged tracheoesophageal puncture (TEP) is a challenging complication of surgical prosthetic voice restoration. Prevention of this complication requires identification of high risk individuals, as well as surgical and prosthetic correlates of TEP enlargement.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Multivariable logistic regression methods were used to analyze preoperative, perioperative, and postoperative risk factors for enlarged TEP in a 5-year retrospective cohort.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Enlarged TEP only occurred in irradiated patients. Adjusting for length of follow-up and timing of TEP, advanced (N2 or N3) nodal disease (OR<sub>adjusted</sub>
: 4.3, 95% 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>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Development of enlarged TEP is a multifactorial process related to both baseline and postoperative factors.</p>
</sec>
</div>
</front>
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