title: The Amatsu's tracheoesophageal shunt: analysis of 84 cases.
abstract: BACKGROUND
  Amatsu's tracheoesophageal shunt can be indicated for vocal rehabilitation in candidates to total laryngectomy. It is performed in the period of the procedure of total laryngectomy and has been indicated due to its technical facility, exemption from the use of voice prosthesis, and lack of additional costs for its maintenance.
  
  
  OBJECTIVE
  To evaluate the results obtained with the Amatsu's tracheoesophageal shunt, along 14 years of experience, in two Brazilian hospitals.
  
  
  METHODS
  Clinical retrospective.
  
  
  METHODS
  From 1991 to 2005, eighty-four patients were submitted to the Amatsu's tracheoesophageal shunt. Seventy-seven (91.7%) were male and seven (8.3%) female, aged between 30 and 82 years, mean age of 57.5 years, and an average age of 52 years. All patients had squamous cell carcinoma of larynx and/or hypopharynx. Sixty-eight (81.0%) were stage III or IV. They were submitted to total laryngectomy and the Amatsu's tracheoesophageal shunt was performed during the tumor removal surgery. The following variables were analyzed: acquisition of intelligible speech, vocal recovery time after surgery, and the occurrence of specific surgical complications of the shunt (pulmonary aspiration).
  
  
  RESULTS
  Seventy-six patients were evaluated with respect to the effectiveness of the technique. Fifty-three patients (70.0%) presented vocalization by the shunt; in 46 patients (60.5%), the speech was fully intelligible. The time required for restoration of speech was 12-87 postoperative days. Of the 83 patients evaluated in relation to the development of complications, 25 (30.1%) presented aspiration by the shunt during oral ingestion. In 23 patients (27.7%), the aspiration was managed conservatively without complications. Two patients (2.4%) required surgical closure of the shunt due to intractable aspiration.
  
  
  CONCLUSIONS
  Vocal rehabilitation with the Amatsu's tracheoesophageal shunt is effective in most patients who underwent total laryngectomy. It can be evidenced by the acquisition of intelligible speech in most patients. The aspiration, although often, is not shown to be a limiting complication.
authors: Department of Surgery, School of Medicine, Federal University of Ouro Preto - UFOP, Ouro Preto, Minas Gerais, Brazil. Electronic address: obzocratto@gmail.com.
authors: Orlando Barreto
authors: OB
authors: Zocratto
authors: Clinic of Otorhinolaryngology and Head and Neck Surgery, Felicio Rocho Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors: Mauro Becker Martins
authors: MB
authors: Vieira
authors: Clinic of Otolaryngology and Head and Neck Surgery, Felicio Rocho Hospital, Belo Horizonte, Minas Gerais, Brazil.
authors: Amélio Ferreira
authors: AF
authors: Maia
authors: Instituto Metropolitano de Ensino Superior - IMES, Ipatinga, Minas Gerais, Brazil.
authors: Ariane Cardoso
authors: AC
authors: Ferreira
authors: Instituto Metropolitano de Ensino Superior - IMES, Ipatinga, Minas Gerais, Brazil.
authors: Laura Tassis
authors: LT
authors: Larangeira
authors: Instituto Metropolitano de Ensino Superior - IMES, Ipatinga, Minas Gerais, Brazil.
authors: Mariana Nassur Rancanti
authors: MN
authors: Penido
authors: Federal University of Ouro Preto - UFOP, Ouro Preto, Minas Gerais, Brazil.
authors: Lucas Leandro Araújo
authors: LL
authors: Silva
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery*; D003906:Developing Countries; D004947:Esophagus / Q000601:surgery; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007822:Laryngeal Neoplasms / Q000534:rehabilitation / Q000601:surgery*; D007825:Laryngectomy / Q000191:economics / Q000379:methods* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013072:Speech, Esophageal / Q000379:methods*; D014132:Trachea / Q000601:surgery
keywords: Amatsu; Total laryngectomy; Tracheoesophageal shunt; Vocal rehabilitation