Factors associated with complications in total laryngectomy without microvascular reconstruction

Head Neck. 2018 Nov;40(11):2409-2415. doi: 10.1002/hed.25363. Epub 2018 Oct 11.

Abstract

Background: There is little population-level data evaluating risk factors for postoperative complications after total laryngectomy.

Methods: We conducted a retrospective review of the American College of Surgeons National Quality Improvement Program identifying patients who underwent total laryngectomy as a primary procedure from 2005 to 2014. Multivariate analysis was performed to identify variables that were independently associated with overall and major complications.

Results: Eight hundred seventy-one cases met inclusion criteria. Three hundred twenty-eight patients (37.7%) had complications, with operative time (hours; P < .0001), class III (P < .001) wound status, and patient age (decade; P = .003) associated with overall complications. Two hundred one patients had major complications that were associated with steroid use (P = .01) and class III (P = .0083) wound classification. Preoperative hematocrit was correlated with a reduction of all and major complications on multivariate analysis (P < .0001 and P = .036).

Conclusion: Identifying and optimizing risk factors may improve outcomes in total laryngectomy.

Keywords: National Surgical Quality Improvement Program; major complications; postoperative complications; total laryngectomy.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Blood Loss, Surgical / physiopathology*
  • Databases, Factual
  • Female
  • Free Tissue Flaps / transplantation
  • Humans
  • Laryngeal Neoplasms / mortality
  • Laryngeal Neoplasms / pathology
  • Laryngeal Neoplasms / surgery*
  • Laryngectomy / adverse effects*
  • Laryngectomy / methods
  • Length of Stay
  • Male
  • Middle Aged
  • Operative Time
  • Patient Readmission / statistics & numerical data*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Steroids / adverse effects*
  • Steroids / therapeutic use
  • Treatment Outcome
  • United States

Substances

  • Steroids