気管切開を先行した喉頭癌手術療法の成績

坂井 梓; 横島 一彦; 中溝 宗永; 稲井 俊太; 酒主 敦子; 加藤 大星; 中石 柾; 大久保 公裕

doi:10.5981/jjhnc.46.334

Negative impact of tracheotomy prior to total laryngectomy for patients with advanced laryngeal cancer

Azusa Sakai, Kazuhiko Yokoshima, Munenaga Nakamizo, Shunta Inai, Atsuko Sakanushi, Taisei Kato, Masashi Nakaishi, Kimihiro Okubo

Author information

Azusa Sakai
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Kazuhiko Yokoshima
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Munenaga Nakamizo
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Shunta Inai
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Atsuko Sakanushi
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Taisei Kato
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Masashi Nakaishi
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School
Kimihiro Okubo
Department of Oto-Rhino-Laryngology, Head and Neck surgery, Nippon Medical School

Keywords: Laryngeal cancer, Total laryngectomy, Tracheotomy, Preservation of the thyroid, Stomal recurrence

JOURNAL FREE ACCESS

2020 Volume 46 Issue 4 Pages 334-339

DOI https://doi.org/10.5981/jjhnc.46.334

Details

Abstract

Tracheotomy prior to definitive cancer treatment is sometimes needed for those patients with airway obstruction due to laryngeal cancer. However, it might have a negative impact on the clinical outcome during and after total laryngectomy. Here we report a retrospective analysis of the effects of tracheotomy prior to surgery.
Patients with laryngeal squamous cell carcinoma who underwent total laryngectomy were selected. Eighty-three consecutive patients who were operated between 2002 and 2017 at Nippon Medical School Hospital were included. Of these 83 patients, 26 underwent prior tracheotomy. The remaining 57 patients who did not suffer airway obstruction did not undergo tracheotomy prior to total laryngectomy. In this study, we compared these two groups from the point of view of the surgical strategy, preservation of the thyroid and parathyroid glands, adverse events and recurrence of cancer.
In cases with prior tracheotomy, more patients underwent extended total laryngectomy with pharyngeal reconstruction. More functional preservation of the thyroid and parathyroid glands was possible in the non-tracheostomy group. There were no significant differences between the two groups regarding adverse events and cancer recurrence.

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