Gastric surgery as a long-term risk factor for malignant lesions of the larynx.
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.
Cianci
Rossella
R
Department of Internal Medicine and Gastroenterology, Catholic University of Medicine and Surgery, Rome, Italy.
Galli
Jacopo
J
Agostino
Stefania
S
Bartolozzi
Francesco
F
Gasbarrini
Antonio
A
Almadori
Giovanni
G
D'Ugo
Domenico
D
Gasbarrini
Giovanni
G
Cammarota
Giovanni
G
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