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Stomal recurrence--etiologic factors and prevention.

M Amatsu, K Makino, M Kinishi

    Auris, Nasus, Larynx
    |January 1, 1985
    PubMed
    Summary

    Stomal recurrence after laryngectomy is more common in patients with preoperative tracheostomies. Preventive measures include wound irrigation, tracheostomy tract excision, and lymphatic dissection, potentially followed by radiotherapy.

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    Area of Science:

    • Otorhinolaryngology
    • Surgical Oncology

    Background:

    • Stomal recurrence is a significant complication following laryngectomy.
    • Understanding the risk factors and etiologies is crucial for prevention.

    Purpose of the Study:

    • To analyze the incidence and potential causes of stomal recurrence after laryngectomy.
    • To propose preventive strategies for reducing stomal recurrence.

    Main Methods:

    • Retrospective analysis of 340 laryngectomies performed between 1969 and 1982.
    • Comparison of stomal recurrence rates between preoperative and operative tracheostomy groups.
    • Literature review and analysis of cases with pretracheal and paratracheal lymphatic dissection.

    Main Results:

    • 20 out of 340 patients (5.9%) developed stomal recurrence.
    • Stomal recurrence rate was higher in the preoperative tracheostomy group (11.5%) compared to the operative group (4.9%).
    • Mean interval to recurrence was 16 months, with potential etiologic factors including tumor cell inoculation and persistent lymph node lesions.

    Conclusions:

    • Preoperative tracheostomy is associated with an increased risk of stomal recurrence.
    • Recommended preventive measures include thorough wound irrigation, complete excision of the tracheostomy tract for preoperatively tracheostomized patients, pretracheal and paratracheal lymphatic dissection for subglottic lesions, and potentially peristomal radiotherapy.

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