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[Infectious complications after surgery for hypopharyngeal and laryngeal carcinomas]
1Service d'ORL, Hôpital Porte Madeleine, CHR d'Orléans, 1, rue Porte Madeleine, BP 2439, 45032 Orléans Cedex 1. Aurelia.Manceau@wanadoo.fr
Objective:
The objective of this study was to analyze the infectious complications of procedures for carcinoma of the hypopharynx and the larynx to optimize the prevention of septic risks.
Material And Methods:
This retrospective study included 608 patients who underwent total (n=270) or partial (n=338) laryngectomy between 1984 and 1999. The procedures were performed under rigorous conditions of surgical asepsis and with prolonged antibiotic chemotherapy depending on the type of laryngectomy and past history of external radiotherapy. Twenty factors were studied. Univariate analysis, including 9 factors, and multivariate analysis were performed.
Results:
The global rate of infectious complications was 11.1%. The percentages of salivary leaks, other wound infections and non-wound infections were respectively 11.9%; 1.5%; 1.5% for total laryngectomy and 1.8%; 2.4%; 3.8% for partial laryngectomy. Statistically significant factors were tumor stage, postoperative hematoma, postoperative lymphorrhea and, to a lesser degree, pharyngeal localization.
Conclusion:
Our rate of infectious complications in oncologic pharyngeal and laryngeal surgery, which is low compared with data in the literature, emphasizes the importance of strict measures of surgical asepsis and prolonged antibiotic chemotherapy as is recommended for so-called contaminated surgery.