title: Gastric surgery as a long-term risk factor for malignant lesions of the larynx.
abstract: BACKGROUND
  Duodenogastroesophageal reflux is common after total or partial gastrectomy. No data are available on the effect of duodenal reflux on the larynx.
  
  
  OBJECTIVE
  Premalignant or malignant changes occur more frequently among subjects with gastric surgery.
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Outpatient setting for upper endoscopy.
  
  
  METHODS
  Ninety-three subjects who had undergone gastric resection at least 5 years previously, and 93 matched dyspeptic individuals who did not undergo gastric surgery.
  
  
  METHODS
  Clinical histories of all patients were obtained and recorded. All subjects underwent an otolaryngologic evaluation.
  
  
  RESULTS
  Of 93 patients with gastric resection, 7 patients had current or previous laryngeal malignancies or current precancerous mucosal changes. In the control group, 1 subject had a leukoplakia on the vocal cord. The adjusted odds ratio (having included sex, age, and alcohol [yes or no] and smoking [yes or no] history in the regression model) was 9.88 (95% confidence interval, 1.01-97.31; likelihood ratio chi2 = 28.77; P<.001). Furthermore, there was a significant increased prevalence of benign laryngeal lesions in patients with gastric resection vs the control group.
  
  
  CONCLUSIONS
  The risk of developing laryngeal malignancies is higher for patients with gastric resection. A periodic otolaryngologic evaluation in subjects with gastric surgery may contribute to early diagnosis of laryngeal disorders.
authors.affiliation: Department of Internal Medicine and Gastroenterology, Catholic University of Medicine and Surgery, Rome, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Cianci
authors.forename: Jacopo
authors.initials: J
authors.lastname: Galli
authors.forename: Stefania
authors.initials: S
authors.lastname: Agostino
authors.forename: Francesco
authors.initials: F
authors.lastname: Bartolozzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Gasbarrini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Almadori
authors.forename: Domenico
authors.initials: D
authors.lastname: D'Ugo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cammarota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D004378:Duodenal Diseases / Q000150:complications*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D005764:Gastroesophageal Reflux / Q000150:complications*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric