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Risk factors for tracheal necrosis after total pharyngolaryngectomy
Author(s) -
Fujiki Masahide,
Miyamoto Shimpei,
Sakuraba Minoru,
Nagamatsu Shogo,
Hayashi Ryuichi
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23737
Subject(s) - medicine , necrosis , logistic regression , retrospective cohort study , surgery , fistula
Background Tracheal necrosis is a severe complication of total pharyngolaryngectomy (TPL). The purpose of this retrospective study was to identify risk factors for tracheal necrosis after TPL. Methods We performed a retrospective chart review of 177 patients who had undergone TPL. The preoperative, operative, and postoperative variables were examined, and possible risk factors for tracheal necrosis were subjected to univariate analysis and multivariate logistic regression. Results Tracheal necrosis occurred in 35 patients (19.8%), and tracheoesophageal fistula subsequently developed in 3 of these patients. Multivariate logistic regression analysis identified total esophagectomy and diabetes mellitus as significant risk factors for tracheal necrosis after TPL. Conclusion The findings of this study will be useful for assessing the risk of tracheal necrosis after TPL. In patients at high risk for tracheal necrosis, efforts should be made to preserve the tracheal circulation and to prevent life‐threatening sequelae if tracheal necrosis occurs. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1207–1210, 2015