Complicaciones post-laringectomía total en cáncer de laringe manejo según factores de riesgo
No hay miniatura disponible
Fecha
2019
Autores
Título de la revista
ISSN de la revista
Título del volumen
Editor
Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Antecedentes: El cáncer de laringe es una de las neoplasias del tracto respiratorio más frecuente. Uno de los tratamientos, es la cirugía. Sin embargo, este procedimiento puede complicarse con una alta frecuencia debido a la presencia de diversos factores. Muchos de estos son diferentes dependiendo de diversas condiciones raciales, geográficas, socio-económicas, etc.
Objetivo: Determinar los factores específicos que aumentan el riesgo de complicaciones postlaringectomía total en pacientes con cáncer de laringe
Metodología: Se realizó un estudio de tipo caso control en el que se incluyeron de manera no estadística, por conveniencia 45 pacientes que fueron intervenidos con laringectomía total entre el 1 de enero del 2010 hasta el 31 de diciembre del 2017 en el hospital Teodoro Maldonado Carbo por diagnóstico de cáncer de laringe. Para el análisis de la asociación estadística se empleó el chi2 de homogeneidad y para la estimación del riesgo el OR.
Resultados: La prevalencia de complicaciones fue del 29%. Las complicaciones más frecuentes fueron fístula faringocutánea (92%), infección del sitio quirúrgico (77%) y sangrado del sitio quirúrgico (54%). Se observó mayor cantidad de complicaciones entre pacientes con sexo masculino (28,9% vs 0%; P < 0.0000), edad mayor a 60 años (28,9% vs 0%; P < 0.0000), diabetes mellitus (47,6% vs 12,5%; P < 0,05; 0R 6 IC95% 1,4 – 28,01), hipoalbuminemia (43,5% vs 13,6%; P < 0.05; OR 4,8; IC95% 1,1 – 21,1) e invasión ganglionar (50% vs 8,7%; P < 0.01; OR 10,5; IC95% 1,9 – 55,9)
Conclusiones: El sexo masculino, una edad > 60 años, diabetes mellitus, hipoalbuminemia e invasión ganglionar son factores de riesgo que determinan un mayor riesgo de complicaciones postquirúrgicas, algunas de estas se asocian con complicaciones específicas
Background: Cancer of the larynx is one of the most frequent respiratory tract neoplasms. One of the treatments is surgery. However, this procedure can be complicated with a high frequency due to the presence of various factors. Many of these are different depending on different racial, geographical, socio-economic conditions, etc. Objective: To determine the specific factors that increases the risk of total postlaringectomy complications in patients with laryngeal cancer. Methodology: A case-control study was conducted in which 45 patients who underwent total laryngectomy between January 1, 2010 and December 31, 2017 were included in the Teodoro Maldonado Carbo Hospital for diagnosing laryngeal cancer. For the analysis of the statistical association, chi2 was used and for OR risk estimation. Results: The prevalence of complications was 29%. The most frequent complications were pharyngocutaneous fistula (92%), infection of the surgical site (77%) and bleeding from the surgical site (54%). A greater number of complications were observed among patients with male sex (28.9% vs. 0%, P <0.0000), age over 60 years (28.9% vs. 0%, P <0.0000), diabetes mellitus (47.6%). % vs 12.5%, P <0.05, 0R 6 IC95% 1.4-28.01), hypoalbuminemia (43.5% vs. 13.6%, P <0.05, OR 4.8, 95% CI 1 , 1 - 21.1) and lymph node invasion (50% vs 8.7%, P <0.01, OR 10.5, IC95% 1.9 - 55.9) Conclusions: Male sex, age> 60 years, diabetes mellitus, hypoalbuminemia and lymph node invasion are risk factors that determine an increased risk of postsurgical complications, some of these are associated with specific complications
Background: Cancer of the larynx is one of the most frequent respiratory tract neoplasms. One of the treatments is surgery. However, this procedure can be complicated with a high frequency due to the presence of various factors. Many of these are different depending on different racial, geographical, socio-economic conditions, etc. Objective: To determine the specific factors that increases the risk of total postlaringectomy complications in patients with laryngeal cancer. Methodology: A case-control study was conducted in which 45 patients who underwent total laryngectomy between January 1, 2010 and December 31, 2017 were included in the Teodoro Maldonado Carbo Hospital for diagnosing laryngeal cancer. For the analysis of the statistical association, chi2 was used and for OR risk estimation. Results: The prevalence of complications was 29%. The most frequent complications were pharyngocutaneous fistula (92%), infection of the surgical site (77%) and bleeding from the surgical site (54%). A greater number of complications were observed among patients with male sex (28.9% vs. 0%, P <0.0000), age over 60 years (28.9% vs. 0%, P <0.0000), diabetes mellitus (47.6%). % vs 12.5%, P <0.05, 0R 6 IC95% 1.4-28.01), hypoalbuminemia (43.5% vs. 13.6%, P <0.05, OR 4.8, 95% CI 1 , 1 - 21.1) and lymph node invasion (50% vs 8.7%, P <0.01, OR 10.5, IC95% 1.9 - 55.9) Conclusions: Male sex, age> 60 years, diabetes mellitus, hypoalbuminemia and lymph node invasion are risk factors that determine an increased risk of postsurgical complications, some of these are associated with specific complications
Descripción
PDF
Palabras clave
Neoplasias laringeas, Complicaciones posoperatorias, Tratamiento quirúrgico, Otorrinolaringología, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador