Total Laryngectomy with Horizontal Mechanical Closure of the Pharyngoesophagectomy: Evaluation of the Effectiveness in Elderly Patients
Int. arch. otorhinolaryngol. (Impr.)
; 23(3): 338-342, July-Sept. 2019. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-1040026
Biblioteca responsável:
BR66.1
ABSTRACT
Abstract Introduction The main modalities of surgical treatment for laryngeal cancer include transoral laser microsurgery (TLM), open preservation surgery, and total laryngectomy (TL). In the elderly, for the presence of comorbidities, the surgical approach more appropriate in many cases remains TL. The use of a stapler for the closure of the esophagus has been introduced to reduce surgical time and postoperative complications such as pharyngocutaneous fistula (PCF). Objective In the present study, we have evaluated the effectiveness of the use of the horizontal mechanical pharyngoesophageal closure in patients who underwent TL. Methods This nonrandomized study was performed on consecutive patients with histopathologically proven squamous cell endolaryngeal carcinoma. The TLwas performed using a linear stapler to mechanically suture the pharyngotomy using the semiclosed technique. Results A total of 33 patients underwent TL, and 13 of themunderwent neck dissection. A total of 15 patients (45.4%) were ≤70 years old, and 18 were > 70 years old. Analyzing the results in relation to age, patients > 70 years old showed tumors at an earlier stage than those aged ≤70 years old. Furthermore, in this group there was a greater number of patients who had comorbidities (p = 0.014). In total, we had 2 (6%) cases of PCF in 6.6% in the group ≤70 years old, and in 5.5% of the group > 70 years old (p = 1.00). Conclusions The use of the stapler for the horizontal closure of the pharyngoesophagectomy in the patients subjected to TL is proven to be useful and safe even when used in elderly patients.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Contexto em Saúde:
Agenda de Saúde Sustentável para as Américas
/
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Objetivo 9: Redução de doenças não transmissíveis
/
Meta 3.4: Reduzir as mortes prematuras devido doenças não transmissíveis
Base de dados:
LILACS
Assunto principal:
Carcinoma de Células Escamosas
/
Neoplasias Laríngeas
/
Laringectomia
Limite:
Idoso
/
Idoso, 80 anos ou mais
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Int. arch. otorhinolaryngol. (Impr.)
Assunto da revista:
Otorrinolaringologia
Ano de publicação:
2019
Tipo de documento:
Artigo
País de afiliação:
Itália
Instituição/País de afiliação:
Azienda Ospedaliera Cannizzaro/IT
/
Magna Graecia University of Catanzaro/IT
/
Santa Marta e Santa Venera Hospital/IT