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Learning Modern Laryngeal Surgery in a Dissection Laboratory
Published on: March 18, 2020
Evaluation of clinical outcomes after partial horizontal laryngectomy
Daniel Abreu Rocha1, Gustavo Fernandes de Alvarenga1, Daniel Marin Ramos2
1Universidade de São Paulo (USP), Faculdade de Medicina (FM), Hospital das Clínicas (HC), São Paulo, SP, Brazil.
Objective:
Evaluate the oncological and functional outcomes of patients submitted to HPL for the treatment of LSCC.
Methods:
A retrospective descriptive study of patients submitted to HPL, performed at a cancer referral center, between January 2011 and December 2017.
Results:
We evaluated 37 patients. The major pathological staging of the primary tumor was pT3 (35.1%), followed by pT2 (32.4%). Five patients required adjuvant radiotherapy; 62.2% of the patients were decannulated by the end of the treatment; 10.8% weren't decannulated; 8.1% underwent a retracheostomy, and 18.9% had total laryngectomy. From the patients submitted to total laryngectomy, 3 cases were due to rehabilitation failure, 2 due to recurrence and 2 cases due to postoperative suture dehiscence. About 89% of the patients resumed oral feeding following the procedure; 86.4% didn't present disease recurrence; 31 patients survived without disease; 3 died from disease-related causes, and 3 from unrelated causes.
Conclusion:
HPL is an alternative procedure to total laryngectomy, presenting adequate rates of local control and overall survival while also maintaining laryngeal function. The main challenge to HPL remains achieving an ideal selection of patients.
Level Of Evidence:
Level IV.
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