“Emergency” laryngectomy and stomal recurrence

Griebie, Matthew S.; Adams, George L.

doi:10.1288/00005537-198709000-00004

Cited by 28 publications

(17 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These maneuvers should also allow clinicians to perform the endoscopic and imaging studies needed to define the feasibility of performing laryngectomy and minimize the necessity for preoperative tracheotomy. When lesions have subglottic extensions of less than 3 cm, we recommend emergency total laryngectomy, as do Grieble and Adams [8]. However, T3 transglottic lesions that have extensions of more than 3 cm may require pretreatment tracheotomy, followed by laryngectomy and radiation therapy.…”

Section: Discussionmentioning

confidence: 99%

The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx

Carrillo

Frías-Mendivil

López-Graniel

et al. 1999

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

To evaluate the impact of the practice of a preoperative tracheotomy and different prognostic factors reported in the literature in patients with transglottic carcinoma of the larynx, a retrospective study was performed in the Instituto Nacional de Cancerologia, Mexico City. In all, 90 cases with T3 transglottic squamous cell carcinoma requiring a total laryngectomy as primary treatment were studied. Prognostic factors such as the Karnofsky index, tumor differentiation, surgical margins and preoperative tracheotomy were analyzed by a Cox's proportional hazards model. The Kaplan-Meier method and log rank test were used to evaluate the disease-free intervals and survival curves. Thirty-two patients had preoperative tracheotomies, while 58 did not. Eighty percent of the patients in the non-preoperative tracheotomy group were alive after 5 years versus 20% of those with preoperative tracheotomies (P < 0.001). Although possibly controversial, our findings indicate that a pretreatment tracheotomy should be avoided in T3 transglottic obstructive lesions. In patients with these lesions and a subglottic extension < or = 3 cm we recommend an emergency total laryngectomy when possible to increase survival and decrease surgical morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

The impact of preoperative tracheotomy on T3 transglottic carcinomas of the larynx

Carrillo

Frías-Mendivil

López-Graniel

et al. 1999

European Archives of Oto-Rhino-Laryngology

View full text Add to dashboard Cite

show abstract

“…Only one substantial series of patients undergoing this operation has been reported. 16 Of their 16 patients, one was female and the mean age and age range were similar to our series. However, 9/16 patients were clinically staged as T3 compared with 2/13 in our series and 10 patients underwent planned postoperative radiotherapy to the neck including the stoma.…”

Section: Discussionmentioning

confidence: 99%

Emergency laryngectomy

et al. 1990

View full text Add to dashboard Cite

Emergency laryngectomy is a laryngectomy carried out for malignant obstruction of the upper airway within 24 h of admission. This combines relief of the obstruction with definitive primary cancer surgery, and is thought to reduce the risk of post-laryngectomy stomal recurrence. During a 5-year period, 13 patients with upper airway obstruction from squamous cell carcinoma were treated in two departments by emergency laryngectomy. Total laryngectomy was carried out after the diagnosis of squamous cell carcinoma of the larynx (n = 11), or piriform fossa (n = 2), had been confirmed by laryngoscopy and frozen section biopsy. The actuarial 5-year survival was 47%, and no patient in this series developed stomal recurrence. The management of the airway obstruction, and the post-laryngectomy complications, did not differ from those encountered with more conventional treatment. Our experience with this approach suggests that emergency laryngectomy is a satisfactory method of managing airway obstruction due to squamous cell carcinoma of the larynx.

show abstract

“…Keim et al (1), in 1965, implicated the pre-resection tracheostomy as the major factor. This has led to the use of ''emergency laryngectomy'' (37,44,48,62,63) to decrease the chance of tumor cell implantation in the stoma. More recently, in 1996, Fagan and Loock (64) examined the association between pre-resection tracheostomy, as an independent variable, and parastomal recurrence in patients treated using a combination of total laryngectomy and radiotherapy.…”

Section: Risk Factors and Pathogenesismentioning

confidence: 99%