ABSTRACT
BACKGROUND: Supracricoid partial laryngectomy has good oncologic results in the treatment of advanced laryngeal cancer with the advantage of preserving larynx phonatory function when compared with total laryngectomy. However the rehabilitation could be a challenge, especially regarding swallowing function. Is supracricoid partial laryngectomy associated with better quality of life than total laryngectomy? METHODS: Survey study that included 33 patients (16 total laryngectomy and 17 supracricoid partial laryngectomy) with advanced larynx cancer surgically treated and fully rehabilitated. The quality of life were evaluated with EORTC QLQ C30 and H&N 35 instrument. RESULTS: Patients who underwent supracricoid partial laryngectomy obtained better scores in global health status-quality of life and general activities and had lower levels of sensory and speech-related symptoms. CONCLUSION: SPL was associated with better quality of life when compared with TL.
Subject(s)
Laryngeal Neoplasms/surgery , Laryngectomy/methods , Quality of Life , Female , Humans , Laryngeal Neoplasms/pathology , Male , Middle Aged , Neoplasm StagingABSTRACT
OBJECTIVE: to evaluate the results of the use of the pectoralis major flap in the reconstruction of head and neck surgeries. METHODS: we conducted a retrospective study with data bank analysis and review of medical records of patients with head and neck cancer operated at the Discipline of Head and Neck Surgery, Surgery Department, São Paulo Holy Home of Mercy, using the pectoralis major flap for reconstruction, in a period of 16 years. We analyzed age, gender, primary site of neoplasia, clinical staging, preoperative radiotherapy (RT) and complications, classified as major and minor. RESULTS: the series comprised 92 patients, of whom 86 (93.5%) were men; the mean age was 61.39 (±11.35) years; the most common primary sites were the mouth, in 35 cases (38%), oropharynx, in 21 (22.8%), and larynx, in 18 cases (19.6%). The majority of patients were in stage IV (88/92, 95.6%) and only four (4.3%) had preoperative RT. The overall complication rate was 48.9%, but only 6.5%, characterized as major complications. In the univariate statistical analysis, we found no factors related to the occurrence of complications. Only the primary neoplasm site presented marginal significance (p = 0.06). CONCLUSION: the pectoralis major flap is safe, with few complete and effective losses in reconstructions in head and neck surgeries, with low rates of major complications, being an option to be considered.
Subject(s)
Head and Neck Neoplasms/surgery , Myocutaneous Flap , Plastic Surgery Procedures/methods , Female , Humans , Male , Middle Aged , Pectoralis Muscles/transplantation , Retrospective StudiesABSTRACT
ABSTRACT Objective: to evaluate the results of the use of the pectoralis major flap in the reconstruction of head and neck surgeries. Methods: we conducted a retrospective study with data bank analysis and review of medical records of patients with head and neck cancer operated at the Discipline of Head and Neck Surgery, Surgery Department, São Paulo Holy Home of Mercy, using the pectoralis major flap for reconstruction, in a period of 16 years. We analyzed age, gender, primary site of neoplasia, clinical staging, preoperative radiotherapy (RT) and complications, classified as major and minor. Results: the series comprised 92 patients, of whom 86 (93.5%) were men; the mean age was 61.39 (±11.35) years; the most common primary sites were the mouth, in 35 cases (38%), oropharynx, in 21 (22.8%), and larynx, in 18 cases (19.6%). The majority of patients were in stage IV (88/92, 95.6%) and only four (4.3%) had preoperative RT. The overall complication rate was 48.9%, but only 6.5%, characterized as major complications. In the univariate statistical analysis, we found no factors related to the occurrence of complications. Only the primary neoplasm site presented marginal significance (p = 0.06). Conclusion: the pectoralis major flap is safe, with few complete and effective losses in reconstructions in head and neck surgeries, with low rates of major complications, being an option to be considered.
RESUMO Objetivo: avaliar os resultados do uso do retalho de músculo peitoral maior nas reconstruções de cirurgias de cabeça e pescoço. Métodos: estudo retrospectivo com análise de banco dados e revisão de prontuários de pacientes com câncer de cabeça e pescoço operados na Disciplina de Cirurgia de Cabeça e Pescoço do Departamento de Cirurgia da Santa Casa de São Paulo em um período de 16 anos, utilizando-se o retalho de músculo peitoral maior para reconstrução. Foram analisados idade, sexo, sítio primário da neoplasia, estadiamento clínico, radioterapia (RT) pré-operatória e as complicações encontradas, classificadas em maiores e menores. Resultados: a casuística foi de 92 pacientes, dos quais 86 (93,5%) eram homens; a média de idade foi de 61,39 (dp±11,35) anos; os sítios primários mais acometidos foram boca em 35 casos (38%); orofaringe em 21 casos (22,8%) e laringe em 18 casos (19,6%). A maioria dos pacientes encontrava-se no estádio IV (88/92; 95,6%) e apenas quatro (4,3%) tinham realizado a RT pré-operatória. A taxa global de complicações foi de 48,9%, mas apenas 6,5% caracterizadas como complicações maiores. Na análise estatística univariada, não foram encontrados fatores relacionados à ocorrência das complicações. Apenas o sítio primário da neoplasia apresentou significância marginal (p=0,06). Conclusão: o retalho de músculo peitoral maior é seguro, com poucas perdas completas e eficaz nas reconstruções em cirurgias de cabeça e pescoço, com baixas taxas de complicações maiores, sendo uma opção a ser considerada.
