title: Early and long-term morbidity after total laryngopharyngectomy.
abstract: To determine the early and long-term morbidity of patients treated with a total laryngopharyngectomy and reconstruction using a jejunum interposition or gastric pull-up procedure. It is a retrospective study; and it is conducted in tertiairy referral center. Sixty-three patients were included in whom 70 reconstructions were performed (51 jejunum interpositions and 19 gastric pull-up procedures) between 1990 and 2007. The studied parameters were success rate of the reconstruction, early and long-term complication rate, and functional outcome including quality of life. Subjective quality of life analysis was determined by two questionnaires: the EORTC Quality of Life Questionnaire (QLQ)-C30 Dutch version 3.0, and the EORTC-Head and Neck (H & N 35). The success rates were 84 and 74%, respectively. The procedures were associated with a high complication rate (63% after jejunum interposition and 89% after gastric pull-up), and a lengthy rehabilitation. Surviving patients were found to have a good long-term quality of life. Complete oral intake was achieved in 97%, and speech rehabilitation in 95%. These procedures are associated with significant morbidity, high complication rates, lengthy rehabilitation, but a good long-term quality of life.
authors.affiliation: Department of Head and Neck Surgery, Erasmus University Medical Center, Daniel den Hoed Cancer Center, 301 Groene Hilledijk, 3075 EA, Rotterdam, The Netherlands. s.keereweer@erasmusmc.nl
authors.forename: Stijn
authors.initials: S
authors.lastname: Keereweer
authors.forename: Johannes H W
authors.initials: JH
authors.lastname: de Wilt
authors.forename: Aniel
authors.initials: A
authors.lastname: Sewnaik
authors.forename: Cees A
authors.initials: CA
authors.lastname: Meeuwis
authors.forename: Hugo W
authors.initials: HW
authors.lastname: Tilanus
authors.forename: Jeroen D F
authors.initials: JD
authors.lastname: Kerrebijn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D010611:Pharyngectomy / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*