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Endoscopic Cholesteatoma Surgery
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Endoscopic laryngo-pharyngeal surgery for elderly patients
Yo Kishimoto1, Hiroyuki Harada1, Makiko Funakoshi2
1Department of Otolaryngology Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Japan.
Auris, Nasus, Larynx
|September 13, 2018
Summary
Endoscopic laryngeal and pharyngeal surgery (ELPS) is a safe and feasible option for very elderly patients with early-stage cancers. This minimally invasive approach demonstrated good outcomes and survival rates in patients aged 75 and older.
Area of Science:
- Otolaryngology
- Oncology
- Geriatric Medicine
Background:
- Early laryngeal and pharyngeal cancers are increasingly diagnosed in elderly patients.
- Minimally invasive endoscopic laryngeal and pharyngeal surgery (ELPS) is a potential treatment, but its safety and efficacy in the elderly are not well-established.
Purpose of the Study:
- To investigate the safety, outcomes, and feasibility of ELPS in very elderly patients (aged 75 years or older).
Main Methods:
- Retrospective review of 19 patients aged 75+ with 29 pharyngeal cancerous or pre-cancerous lesions treated with ELPS between 2010 and 2016.
- Analysis of 26 resections, focusing on clinical course, comorbidities, surgical time, hospitalization, oral intake resumption, complications, and survival rates.
Main Results:
- The average surgical time was 54.3 minutes, and the average hospitalization was 18.8 days.
- All patients eventually resumed oral nourishment without percutaneous endoscopic gastrostomy dependency.
- Complications (bleeding, aspiration pneumonia) occurred in two cases each but were managed safely. Three-year overall and disease-specific survival rates were 90.2% and 100%, respectively.
Conclusions:
- Endoscopic laryngeal and pharyngeal surgery (ELPS) is a safe and feasible treatment for pharyngeal lesions in very elderly patients.
- The procedure demonstrated acceptable complication rates and excellent survival outcomes in this population.
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