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Revista do Colégio Brasileiro de Cirurgiões

Print version ISSN 0100-6991On-line version ISSN 1809-4546

Abstract

AQUINO, José Luís Braga de et al. Results of conservative surgery in larynx carcinoma. Rev. Col. Bras. Cir. [online]. 2002, vol.29, n.2, pp.99-105. ISSN 1809-4546.  http://dx.doi.org/10.1590/S0100-69912002000200008.

BACKGROUND: This is of a retrospective study of the results obtained from partial laryngectomy for epidermoid carcinoma. METHODS: Twenty-eight males (93.5%) and 2 females (6.5%), between 42 years and 66 years old (mean age, 58 years). The surgical procedure varied in accordance to the site, extension and stage of the tumor. The technique most used was the frontolateral laryngectomy, performed on 12 patients (40%), followed by the vertical laryngectomy on 8 patients (26.6%), the supraglottic laryngectomy on 4 patients (13.3%), supracricoid laryngectomy on 4 patients (13.3%), near total laryngectomy on 1 patient (3.3%) and chordectomy on 1 patient (3.3%). RESULTS: An early postoperative assessment showed that 3 patients (10%) had complications. Two of them had pharyngocutaneous fistulas that responded well to conservative treatment and the remaining patient had pneumothorax, which improved after thoracic drainage. Deglutition assessment revealed that 5 patients (16.6%) presented difficulty in oral ingestion as a result of recurrent aspirations that occurred at periods that varied between 15 days to 180 days (average 180 days) and caused recurrent pneumonia. The only remaining option was total laryngectomy. The next assessment was performed after a period that varied between 6 months to 125 months (mean of 29 months) and revealed that 4 patients (13.3%) had recurrence in the same region. Two of these patients underwent vertical laryngectomy, 1 patient had a frontolateral laryngectomy and the remaining patient underwent supracricoid laryngectomy. All patients underwent total laryngectomy and/or radiotherapy, but the disease caused the death of 2 patients. Twenty four patients (84%) demonstrated that their voice was preserved and at the end of the assessment, 90% of the patients were alive and without any signs of the disease. These patients had a far better quality of life as they presented fairly satisfactory voice and oral ingestion. CONCLUSION: The conservative surgery of the larynx provided good disease control and increased the patient's life span.

Keywords : Larynx; Carcinoma; Laryngectomy.

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