Systematic review and meta-analysis of the complications of salvage total laryngectomy. Issue 1 (January 2017)

• Record Type: Journal Article
• Authors: Hasan, Z.; Dwivedi, R.C.; Gunaratne, D.A.; Virk, S.A.; Palme, C.E.; Riffat, F.
• Is Part Of: European journal of surgical oncology. Volume 43:Issue 1(2017:Jan.)
• Page Start: 42
• Page End: 51
• Publication Date: 2017-01
• Subjects: Laryngeal cancer -- Laryngectomy -- Salvage surgery -- Pharyngocutaneous fistula -- Complications -- Head & neck surgery; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2016.05.017
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Background and objectives: Management paradigms in laryngeal cancer have shifted to "organ preservation" chemoradiotherapy protocols. In the event of treatment failure, salvage total laryngectomy remains the only curative treatment option. However a comprehensive review of the complications of this procedure has not been reported. Methods: A systematic review of the literature was performed using keywords "salvage laryngectomy" to retrieve relevant publications between January 2000 and August 2015. Results: Of the 407 articles retrieved from the literature search, 50 studies encompassing 3292 patients were included. Forty-nine studies reported pharyngocutaneous fistula which occurred in 859 patients (pooled incidence 28.9%; 95% confidence intervals 25.5–32.5%). Twenty-four studies reported complications in addition to PCF and these included wound complications (infection, dehiscence and necrosis), dysphagia, bleeding, and pharyngeal and stomal stenosis. Conclusions: Overall complication rate was 67.5%, Pharyngocutaneous fistula was the commonest complication with a pooled incidence of 28.9%.