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Complications in One-Third Undergoing Total Laryngectomy

Readmission linked to preoperative hypoalbuminemia, post-op wound complications


WEDNESDAY, Jan. 11, 2017 (HealthDay News) -- About one-third of patients undergoing total laryngectomy (TL) have complications and 13.9 percent are readmitted within 30 days, according to a study published online Dec. 27 in Cancer.

Ryan P. Goepfert, M.D., from the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a retrospective cohort study involving all patients who underwent TL at the center from Jan. 1, 2010, through June 30, 2013. They extracted patient demographics, treatment history, hospital length of stay, and 30-day post-TL complications and readmissions from the medical records for 245 patients.

The researchers found that complications occurred in 83 patients (33.9 percent), including three deaths (1.2 percent). Fifty-three patients (21.6 percent) had wound complications, and 34 were pharyngocutaneous fistulas (PCFs, 13.9 percent overall). Readmission within 30 days occurred in 34 patients (13.9 percent). In multivariate analysis, wound complications were associated with former and current smokers (odds ratios, 5.1 [P = 0.03] and 5.8 [P = 0.02], respectively); PCFs correlated with prior wide-field, but not prior narrow-field radiation (odds ratios, 3.1 [P = 0.01) and 1.4 [P = 0.61], respectively); length of stay correlated with the type of flap and postoperative hematomas (P = 0.002 and 0.05, respectively); and readmission correlated with preoperative hypoalbuminemia and postoperative wound complications (P = 0.003 and P < 0.001, respectively).

"These data can inform quality improvement efforts and the counseling of high-risk patients undergoing TL," the authors write.

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