Objective: To evaluate the frequency ofpost-operative complications of laryngeal cancer surgery and to analyze its association with various tumour, patient and treatment related factors. Study Design: Case series. Setting & Duration: Department of Otolaryngology, Head and Neck Surgery, Civil Hospital, Karachi from January 2003 to January 2008. Methodology: Fifty patients of laryngeal carcinoma, who underwent different surgical procedures ranging from conservation to radical laryngectomies (TL, ETL) were included, to evaluate the presentations of various post operative complications. Those with N3 nodal status and with distant metastasis were excluded. All patients were reviewed to assess those possible factors that contribute to postoperative complications such as topography, stage of disease and surgical techniques. Data was analysed on SPSS 13.0 for frequency and percentage. Results: Majority of tumors were Squamous cell carcinoma (9891o) while only one (201o) case was of chondrosarcoma. Supraglottic tumours were found in 14 patients (2801o), glottic in 16 patients (3201o) and transglottic in 20 patients (4091o). Total laryngectomy (TL) was performed in 31 patients (62%), extended laryngectomy (ETL) was done in 10 patients (2001o), while conservation laryngeal surgery (CLS) performed in 9patients(1801o). Postoperative complications following different laryngectomy procedures, includedphayngocutaneous fistula in 9(1801o), nodal recurrence in 7(1401o), stomal recurrence in 3(601o), stomal stenosis in 3(6%), local recurrence in 2(4%), pharyngeal stenosis in 3(6%), post operative hemorrhage in 2(401o), hypothyroidism in 1(201o) and distant metastasis in 1(201o). Over all complications were seen in 11 patients (22%). Topography of the tumor (SG) and type of surgery (ETL) were significantly associated with postoperative complications p < 0.05. Conclusion: Pharyngocutaneous fistula is the commonest complication after total laryngectomy advance staged tumours especially supraglottic tumours with extensive soft issue infiltration were significantly associated with the pharyngocutaneous fistula.
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