After a total laryngectomy the appearance of a stomal recurrent (S.R.) strongly influences prognosis. The poor chances of surgical and/or radiotherapeutic recovery have encouraged research of those factors which might make possible to determine their origin. A series of 335 total laryngectomies, performed from 1967 to 1982 at the E.N.T. Department of the Regional Hospital of Varese, have been considered here and retrospectively evaluated. The overall incidence of S.R. was 2.68% (9 cases out of 335) and patient follow-up lasted from 2 to 17 years. Correlations were sought between S.R. and factors such as: primary site, TNM stage, surgical or radiotherapeutic pre-operatory treatments, radiotherapeutic post-operative treatment and tracheotomy. From the statistical point of view, fully acceptable results were obtained in regard to site: hypoglottic tumours have a slightly higher incidence of relapses than supraglottic lesions (11.11% vs O); clincial TNM stages have likewise proved valuable in predicting S.R. No valid correlation was drawn with either pre- or post-operatory radiotherapy. A prior tracheotomy appears to be the most important risk factor; the incidence of S.R. was 20% vs 10% in those patients who had undergone conservative laryngeal surgery and 0.78% when tracheotomy had been performed immediately before total laryngectomy. The tracheostoma level proved quite important suggesting that such a procedure should be performed, together with total laryngectomy, as low as possible in the tracheal rings.
|Translated title of the contribution||Post laryngectomy stomal recurrences|
|Number of pages||9|
|Journal||Acta Otorhinolaryngologica Italica|
|Publication status||Published - 1985|
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